Healthcare Provider Details
I. General information
NPI: 1831990563
Provider Name (Legal Business Name): ALEXANDER HARVEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6425 RICHMOND RD
WILLIAMSBURG VA
23188-7202
US
IV. Provider business mailing address
5684 SAINT LEGER DR
PROVIDENCE FORGE VA
23140-4558
US
V. Phone/Fax
- Phone: 757-345-3242
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225200000X |
| Taxonomy | Physical Therapy Assistant |
| License Number | 2306605948 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: