Provider Demographics
NPI:1790422459
Name:PRETTYMAN, ALEXIS V
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:V
Last Name:PRETTYMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1859
Mailing Address - Country:US
Mailing Address - Phone:610-906-9282
Mailing Address - Fax:
Practice Address - Street 1:952 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-1859
Practice Address - Country:US
Practice Address - Phone:610-906-9282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-15
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer