Provider Demographics
NPI:1417549643
Name:COSSEY, ALEXANDER EMMETT (DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:EMMETT
Last Name:COSSEY
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 1:211 TANK FARM RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7509
Mailing Address - Country:US
Mailing Address - Phone:805-439-3900
Mailing Address - Fax:805-439-3901
Practice Address - Street 1:211 TANK FARM RD STE A
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7509
Practice Address - Country:US
Practice Address - Phone:805-439-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299708225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist