Provider Demographics
NPI:1013494368
Name:SHOWERS, ALEXIS BROOKE (PTA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:BROOKE
Last Name:SHOWERS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:BROOKE
Other - Last Name:DONOVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4045 W ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-8965
Mailing Address - Country:US
Mailing Address - Phone:231-935-0900
Mailing Address - Fax:231-935-0312
Practice Address - Street 1:2636 OAKHILL LN APT 308
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5052
Practice Address - Country:US
Practice Address - Phone:231-622-2161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer