Provider Demographics
NPI:1265108419
Name:CALDWELL, ALEXANDRA BROOKE
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:BROOKE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9041 EAGLE VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6994
Mailing Address - Country:US
Mailing Address - Phone:205-767-4032
Mailing Address - Fax:
Practice Address - Street 1:1770 BATHGATE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7334
Practice Address - Country:US
Practice Address - Phone:484-884-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL225100000X
PAPT030426225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist