Provider Demographics
NPI:1336318500
Name:ALEXANDER, KIERSTEN (PT)
Entity Type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-0246
Mailing Address - Country:US
Mailing Address - Phone:888-909-6017
Mailing Address - Fax:
Practice Address - Street 1:16600 W SPRAGUE RD
Practice Address - Street 2:SUITE 365
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-6318
Practice Address - Country:US
Practice Address - Phone:216-227-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT007216208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation