Provider Demographics
NPI:1225485956
Name:WINTER, ALEXANDRA LEIGH (DPT)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:LEIGH
Last Name:WINTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:37638 SANTA ANNA ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-1783
Mailing Address - Country:US
Mailing Address - Phone:586-484-8403
Mailing Address - Fax:
Practice Address - Street 1:3101 S GULLEY RD STE F
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4406
Practice Address - Country:US
Practice Address - Phone:734-407-2500
Practice Address - Fax:313-792-8962
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0119199225100000X
MI5501017959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist