Provider Demographics
NPI:1962044313
Name:PUMPHREY, ALEXANDRA R (ATC)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:R
Last Name:PUMPHREY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9705 RANSOM HILLS TER
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23237-3570
Mailing Address - Country:US
Mailing Address - Phone:804-922-6007
Mailing Address - Fax:
Practice Address - Street 1:9705 RANSOM HILLS TER
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23237-3570
Practice Address - Country:US
Practice Address - Phone:804-922-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260019342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer