Provider Demographics
NPI:1477384824
Name:OSMOLOWSKI, ALEXIS LAUREN (DPT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:LAUREN
Last Name:OSMOLOWSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 MARKET ST APT 812
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1319
Mailing Address - Country:US
Mailing Address - Phone:774-232-8272
Mailing Address - Fax:
Practice Address - Street 1:2350 W OREGON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4122
Practice Address - Country:US
Practice Address - Phone:215-336-6630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT032604225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist