Provider Demographics
NPI:1225366537
Name:ALEXANDER, TERRI ANN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:ANN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WINDY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-7212
Mailing Address - Country:US
Mailing Address - Phone:937-629-0177
Mailing Address - Fax:
Practice Address - Street 1:823 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-3609
Practice Address - Country:US
Practice Address - Phone:937-717-4828
Practice Address - Fax:937-717-6539
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.016045171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor