MEDICARE: ALEXIS KAY ANDERSON PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1184314049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS KAY ANDERSON PT, DPT

Provider Business Mailing Address
First Line	:	1460 E BELL RD APT 1026
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-2780
Country	:	US
Telephone Number	:	715-651-9335
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 W CAREFREE HWY STE B5
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-3201
Country	:	US
Telephone Number	:	623-434-4655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2023
Last Update Date	:	05/12/2023

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