Healthcare Provider Details

I. General information

NPI: 1639642960
Provider Name (Legal Business Name): JOSEPH PAUL ALEXANDER PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2019
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3773 OLENTANGY RIVER RD
COLUMBUS OH
43214-3425
US

IV. Provider business mailing address

1148 W BELMONT AVE APT 2R
CHICAGO IL
60657-6616
US

V. Phone/Fax

Practice location:
  • Phone: 614-407-8645
  • Fax:
Mailing address:
  • Phone: 330-473-9543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number17831
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070025068
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: