Provider Demographics
NPI:1245755412
Name:JONES, ALEXANDREA (DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDREA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5641 HUNTERS VALLEY CT APT F
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-2281
Mailing Address - Country:US
Mailing Address - Phone:618-308-0794
Mailing Address - Fax:
Practice Address - Street 1:6022 S LINDBERGH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7040
Practice Address - Country:US
Practice Address - Phone:314-845-7751
Practice Address - Fax:314-845-7752
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017028629225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist