Provider Demographics
NPI:1376073098
Name:SPELMAN, ALEXANDRA M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:M
Last Name:SPELMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 S GILBERT ST APT D
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2905
Mailing Address - Country:US
Mailing Address - Phone:631-678-7330
Mailing Address - Fax:
Practice Address - Street 1:420 E 120TH AVE
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-1127
Practice Address - Country:US
Practice Address - Phone:303-280-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0014936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist