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General NPI Number Information
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NPI Number | 1780026187
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Entity Type | Individual
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Provider Name | KELLY MICHELLE ALEXANDER D.P.T
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Gender | Female
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 10209 SUNDANCE CT
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City | POTOMAC
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State | MD
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Zip | 20854-4052
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Country | US
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Telephone | 240-701-4126
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Fax |
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Provider Business Mailing Address
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Address Line | 14635 CUTSTONE WAY
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City | SILVER SPRING
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State | MD
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Zip | 20905-7445
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Country | US
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Telephone | 240-701-4126
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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 | PT24369
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License Number State | FL
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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 | 26223
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License Number State | MD
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