MEDICARE: ALEXANDRA HEINRICH 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	11983	MN

General Provider Information

NPI Number	:	1477147551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA HEINRICH DPT

Provider Business Mailing Address
First Line	:	575 CLEVELAND AVE S APT 8
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-1261
Country	:	US
Telephone Number	:	651-500-9569
Fax Number	:

Provider Business Practice Location Address
First Line	:	480 HIGHWAY 96 E STE 120
Second Line	:
City	:	VADNAIS HEIGHTS
State	:	MN
Zip	:	55127-2557
Country	:	US
Telephone Number	:	651-482-8486
Fax Number	:

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

Provider Enumeration Date	:	03/01/2021
Last Update Date	:	03/01/2021

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