Provider Demographics
NPI:1013116151
Name:ALEXANDER, WENDY SHEREE (P T)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SHEREE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 W HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-4519
Mailing Address - Country:US
Mailing Address - Phone:918-249-9649
Mailing Address - Fax:918-249-9649
Practice Address - Street 1:4300 W HOUSTON ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-4519
Practice Address - Country:US
Practice Address - Phone:918-249-9649
Practice Address - Fax:918-249-9649
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT 2990225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist