Provider Demographics
NPI:1508379496
Name:HULL, ALEXANDRA (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:HULL
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:HOYT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4177 VILLAGE PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49685-7237
Mailing Address - Country:US
Mailing Address - Phone:231-421-5805
Mailing Address - Fax:231-421-5308
Practice Address - Street 1:4177 VILLAGE PARK DR.
Practice Address - Street 2:SUITE B
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49685
Practice Address - Country:US
Practice Address - Phone:231-421-5805
Practice Address - Fax:231-421-5308
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010183472251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic