Healthcare Provider Details

I. General information

NPI: 1598738007
Provider Name (Legal Business Name): ALEXANDER MICHAEL PINTO ED.D., ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 POWELL CT
BRENTWOOD TN
37027-5079
US

IV. Provider business mailing address

103 POWELL CT
BRENTWOOD TN
37027-5079
US

V. Phone/Fax

Practice location:
  • Phone: 615-416-3868
  • Fax:
Mailing address:
  • Phone: 615-416-3868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number685
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: