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General NPI Number Information
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NPI Number | 1053635672
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Entity Type | Individual
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Provider Name | ALEXIS LEANN GERMAN
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Gender | Female
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Dates
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Enumeration Date | 03/25/2010
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Last Update Date | 03/25/2010
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Provider Practice Location Address
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Address Line | 41 HOSPITAL DR
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City | LEXINGTON
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State | TN
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Zip | 38351-1423
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Country | US
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Telephone | 731-968-6629
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Fax |
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Provider Business Mailing Address
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Address Line | 654 N WALNUT ST
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City | VAN WERT
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State | OH
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Zip | 45891-1233
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA0000001846
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License Number State | TN
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