Provider Demographics
NPI:1043672363
Name:TURGEON, ALEX MICHAEL
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:MICHAEL
Last Name:TURGEON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 TOMAH CT NW
Mailing Address - Street 2:
Mailing Address - City:LONSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55046-9552
Mailing Address - Country:US
Mailing Address - Phone:952-846-8518
Mailing Address - Fax:
Practice Address - Street 1:213 TOMAH COURT
Practice Address - Street 2:
Practice Address - City:LONSDALE
Practice Address - State:MN
Practice Address - Zip Code:55046
Practice Address - Country:US
Practice Address - Phone:952-846-8518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer