Provider Demographics
NPI:1497452916
Name:TIRKO, ALEXANDER (PT)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:TIRKO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:FRACKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17931-1643
Mailing Address - Country:US
Mailing Address - Phone:888-929-7677
Mailing Address - Fax:888-929-7677
Practice Address - Street 1:846 E WICONISCO AVE
Practice Address - Street 2:
Practice Address - City:TOWER CITY
Practice Address - State:PA
Practice Address - Zip Code:17980-1609
Practice Address - Country:US
Practice Address - Phone:888-929-7677
Practice Address - Fax:888-929-7677
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029331225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist