MEDICARE: ALEXIS GARDUNO

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	14201	TN

General Provider Information

NPI Number	:	1568108876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS GARDUNO

Provider Business Mailing Address
First Line	:	4109 MOUNTAIN VIEW AVE STE 100
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37415-2096
Country	:	US
Telephone Number	:	423-842-9322
Fax Number	:	866-591-0619

Provider Business Practice Location Address
First Line	:	1965 NORTHPOINT BLVD
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4060
Country	:	US
Telephone Number	:	423-842-9322
Fax Number	:	866-591-0619

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

Provider Enumeration Date	:	05/10/2022
Last Update Date	:	02/03/2026

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Directions to “ ALEXIS GARDUNO ” Practice Location

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