Provider Demographics
NPI:1073014767
Name:STEWARD, ALEXANDRIA BROOKE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:BROOKE
Last Name:STEWARD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:BROOKE
Other - Last Name:HAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2155 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-1816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2155 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-1816
Practice Address - Country:US
Practice Address - Phone:317-204-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017841225100000X
IN05012956A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist