Provider Demographics
NPI:1902387251
Name:MUFFLY, ALEXA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:MARIE
Last Name:MUFFLY
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 1:323 FAIRMONT DR
Mailing Address - Street 2:
Mailing Address - City:WATSONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17777-9412
Mailing Address - Country:US
Mailing Address - Phone:570-452-6029
Mailing Address - Fax:
Practice Address - Street 1:255 N 29TH ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2910
Practice Address - Country:US
Practice Address - Phone:717-516-1505
Practice Address - Fax:717-256-4829
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist