Provider Demographics
NPI:1073157525
Name:BATES, ALEX S (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:S
Last Name:BATES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8607 US HIGHWAY 23 S
Mailing Address - Street 2:
Mailing Address - City:OSSINEKE
Mailing Address - State:MI
Mailing Address - Zip Code:49766-9563
Mailing Address - Country:US
Mailing Address - Phone:989-916-6808
Mailing Address - Fax:
Practice Address - Street 1:8607 US HIGHWAY 23 S
Practice Address - Street 2:
Practice Address - City:OSSINEKE
Practice Address - State:MI
Practice Address - Zip Code:49766-9563
Practice Address - Country:US
Practice Address - Phone:989-916-6808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5660225100000X
MI5501020026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist