Provider Demographics
NPI:1669012407
Name:MILDRUM, ALEXANDRA RICHARDS (DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RICHARDS
Last Name:MILDRUM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7218 MARGARET AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-4621
Mailing Address - Country:US
Mailing Address - Phone:434-944-1043
Mailing Address - Fax:
Practice Address - Street 1:2436 COLONY CROSSING PL
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4281
Practice Address - Country:US
Practice Address - Phone:804-918-8515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist