Provider Demographics
NPI:1184314049
Name:ANDERSON, ALEXIS KAY (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:KAY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 E BELL RD APT 1026
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2780
Mailing Address - Country:US
Mailing Address - Phone:715-651-9335
Mailing Address - Fax:
Practice Address - Street 1:3120 W CAREFREE HWY STE B5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-3201
Practice Address - Country:US
Practice Address - Phone:623-434-4655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist