Provider Demographics
NPI:1639784200
Name:TESSMAN, ALEX TAYLOR (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:TAYLOR
Last Name:TESSMAN
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 1:500 CALLOWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-3310
Mailing Address - Country:US
Mailing Address - Phone:501-765-7915
Mailing Address - Fax:
Practice Address - Street 1:500 CALLOWAY AVE
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-3310
Practice Address - Country:US
Practice Address - Phone:501-765-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4772208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation