Provider Demographics
NPI:1003524331
Name:GLASBY, ALEXIS (BS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:GLASBY
Suffix:
Gender:F
Credentials:BS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 PARKER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-1910
Mailing Address - Country:US
Mailing Address - Phone:314-278-4474
Mailing Address - Fax:
Practice Address - Street 1:4900 MERIDIAN ST NW
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:AL
Practice Address - Zip Code:35762-7500
Practice Address - Country:US
Practice Address - Phone:256-372-8457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer