Provider Demographics
NPI:1235699588
Name:GARLO, ALEXANDER (DPT)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:GARLO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 ELM ST
Mailing Address - Street 2:STE 9
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1540
Mailing Address - Country:US
Mailing Address - Phone:413-736-2250
Mailing Address - Fax:413-736-2254
Practice Address - Street 1:1111 ELM ST STE 9
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1540
Practice Address - Country:US
Practice Address - Phone:413-736-2250
Practice Address - Fax:413-736-2254
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-22
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA892251X0800X
MA21456225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty