Healthcare Provider Details

I. General information

NPI: 1679492607
Provider Name (Legal Business Name): ALEJANDRIA SERAIAH KASPARIE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 N MAIN ST
GUYMON OK
73942-3303
US

IV. Provider business mailing address

704 W 2ND ST
BEAVER OK
73932-3476
US

V. Phone/Fax

Practice location:
  • Phone: 580-338-4676
  • Fax:
Mailing address:
  • Phone: 580-216-3006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6893
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: