Provider Demographics
NPI:1154688331
Name:KING, ALEX J (MPT, CCI)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:J
Last Name:KING
Suffix:
Gender:M
Credentials:MPT, CCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 OHIO PIKE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3721
Mailing Address - Country:US
Mailing Address - Phone:513-247-4340
Mailing Address - Fax:512-247-4360
Practice Address - Street 1:463 OHIO PIKE
Practice Address - Street 2:SUITE 203
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3721
Practice Address - Country:US
Practice Address - Phone:513-247-4340
Practice Address - Fax:512-247-4360
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT011695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist