Healthcare Provider Details

I. General information

NPI: 1730562729
Provider Name (Legal Business Name): ALEXANDRA COURTS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEX RANDOLPH

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 07/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5267 JOSEPH LN
MASON OH
45040
US

IV. Provider business mailing address

5267 JOSEPH LN
MASON OH
45040-1272
US

V. Phone/Fax

Practice location:
  • Phone: 513-417-0787
  • Fax:
Mailing address:
  • Phone: 513-417-0787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.015267
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: