Provider Demographics
NPI:1972708204
Name:FLEMING, ALFREDA G (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:ALFREDA
Middle Name:G
Last Name:FLEMING
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 GAINSBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-6804
Mailing Address - Country:US
Mailing Address - Phone:804-382-1134
Mailing Address - Fax:
Practice Address - Street 1:7015 CARNATION ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-5294
Practice Address - Country:US
Practice Address - Phone:804-272-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306001191225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant