MEDICARE: MRS. LYNDA GAIL ALEXANDER 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	2251P0200X	Pediatric Physical Therapist	PT001429	GA

General Provider Information

NPI Number	:	1912247578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNDA GAIL ALEXANDER DPT

Provider Business Mailing Address
First Line	:	503 RICHEY PL
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-3644
Country	:	US
Telephone Number	:	770-632-0803
Fax Number	:	770-632-0803

Provider Business Practice Location Address
First Line	:	503 RICHEY PL
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-3644
Country	:	US
Telephone Number	:	770-632-0803
Fax Number	:	770-632-0803

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

Provider Enumeration Date	:	02/19/2013
Last Update Date	:	02/19/2013

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