Provider Demographics
NPI:1760906192
Name:DAVIS, ALEXA MARIE (PT, DPT, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT, DPT, ATC, CSCS
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:MARIE
Other - Last Name:SARMIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, ATC, CSCS
Mailing Address - Street 1:360 LOG HOUSE CT
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4189
Mailing Address - Country:US
Mailing Address - Phone:678-596-3635
Mailing Address - Fax:
Practice Address - Street 1:1000 JOHNSON FERRY RD STE A115
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2110
Practice Address - Country:US
Practice Address - Phone:404-367-2085
Practice Address - Fax:770-579-7060
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012983225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist