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General NPI Number Information
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NPI Number | 1114693074
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Entity Type | Individual
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Provider Name | ALEXANDRA ALDRIDGE DPT
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Gender | Female
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 1065 CLAYTON ST STE 9
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City | CONWAY
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State | AR
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Zip | 72032-4335
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Country | US
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Telephone | 501-328-5878
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Fax | 501-336-0119
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Provider Business Mailing Address
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Address Line | PO BOX 1168
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City | CONWAY
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State | AR
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Zip | 72033-1168
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Country | US
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Telephone | 501-328-5878
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Fax | 501-336-0119
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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 | 5044
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License Number State | AR
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