Healthcare Provider Details

I. General information

NPI: 1225366537
Provider Name (Legal Business Name): TERRI ANN ALEXANDER L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 N LIMESTONE ST
SPRINGFIELD OH
45503-3609
US

IV. Provider business mailing address

3100 WINDY RIDGE DR
SPRINGFIELD OH
45502-7212
US

V. Phone/Fax

Practice location:
  • Phone: 937-717-4828
  • Fax: 937-717-6539
Mailing address:
  • Phone: 937-629-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number33.016045
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: