Provider Demographics
NPI:1780026187
Name:ALEXANDER, KELLY MICHELLE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:MICHELLE
Last Name:ALEXANDER
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 1:14635 CUTSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-7445
Mailing Address - Country:US
Mailing Address - Phone:240-701-4126
Mailing Address - Fax:
Practice Address - Street 1:10209 SUNDANCE CT
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-4052
Practice Address - Country:US
Practice Address - Phone:240-701-4126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24369225100000X
MD26223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist