Provider Demographics
NPI:1861686677
Name:NOON, ALEXANDER (PTA)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:NOON
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HIMILAYA CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-4811
Mailing Address - Country:US
Mailing Address - Phone:314-406-8636
Mailing Address - Fax:
Practice Address - Street 1:3 HIMILAYA CT
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-4811
Practice Address - Country:US
Practice Address - Phone:314-406-8636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA7206R225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant