Provider Demographics
NPI:1346794229
Name:BEEBE, ALEXANDER E (DPT, OCS)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:E
Last Name:BEEBE
Suffix:
Gender:M
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 MONTCLAIR PLACE
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078
Mailing Address - Country:US
Mailing Address - Phone:404-556-2100
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:555 10TH STREET NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318
Practice Address - Country:US
Practice Address - Phone:404-477-8888
Practice Address - Fax:770-493-5549
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist