Healthcare Provider Details

I. General information

NPI: 1578479655
Provider Name (Legal Business Name): ALEXANDER RECKER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 CENTENNIAL LOOP STE A
EUGENE OR
97401-7917
US

IV. Provider business mailing address

2650 SUZANNE WAY STE 200
EUGENE OR
97408-7619
US

V. Phone/Fax

Practice location:
  • Phone: 541-342-1632
  • Fax:
Mailing address:
  • Phone: 541-342-1632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number65859
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: