Provider Demographics
NPI:1558796961
Name:ALEXANDER PEDIATRIC THERAPIES LLC
Entity Type:Organization
Organization Name:ALEXANDER PEDIATRIC THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FINET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-236-1023
Mailing Address - Street 1:3256 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-3812
Mailing Address - Country:US
Mailing Address - Phone:480-236-1023
Mailing Address - Fax:480-436-6043
Practice Address - Street 1:3256 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-3812
Practice Address - Country:US
Practice Address - Phone:480-236-1023
Practice Address - Fax:480-436-6043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health