Provider Demographics
NPI:1568813731
Name:HOWLAND, ALEXIS ROSE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ROSE
Last Name:HOWLAND
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 1:2630 E JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-4129
Mailing Address - Country:US
Mailing Address - Phone:313-259-7294
Mailing Address - Fax:
Practice Address - Street 1:3455 PEACHTREE PKWY STE 206
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-9104
Practice Address - Country:US
Practice Address - Phone:678-473-1081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017570225100000X
GAPT015588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist