Provider Demographics
NPI:1295350585
Name:WARTHLING, ALEX DAVID (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:DAVID
Last Name:WARTHLING
Suffix:
Gender:M
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 1:3159 BUGLE BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:SUGARCREEK TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45305-8854
Mailing Address - Country:US
Mailing Address - Phone:716-308-2021
Mailing Address - Fax:
Practice Address - Street 1:3218 INDIAN RIPPLE RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-3637
Practice Address - Country:US
Practice Address - Phone:937-426-8481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018606225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist