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General NPI Number Information
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NPI Number | 1659921708
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Entity Type | Individual
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Provider Name | ALEJANDRO GONZALEZ
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Gender | Male
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 201 CENTRE DR STE 102
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City | STEPHENS CITY
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State | VA
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Zip | 22655-4073
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Country | US
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Telephone | 540-227-0043
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Fax |
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Provider Business Mailing Address
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Address Line | 104 MAVERICK CT
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City | STEPHENS CITY
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State | VA
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Zip | 22655-4833
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Country | US
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Telephone | 267-968-9966
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305213174
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License Number State | VA
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