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General NPI Number Information
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NPI Number | 1003763517
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Entity Type | Individual
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Provider Name | ALEX LOGAN ESQUIVEL
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Gender | Male
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 1660 W GARTON ROAD OZ
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City | OZARK
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State | MO
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Zip | 65721
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Country | US
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Telephone | 417-551-9669
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Fax |
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Provider Business Mailing Address
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Address Line | 3126 E VALLEY WATER MILL RD APT 3709
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City | SPRINGFIELD
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State | MO
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Zip | 65803-4918
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2026009433
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License Number State | MO
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