Provider Demographics
NPI:1912247578
Name:ALEXANDER, LYNDA GAIL (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:GAIL
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:LYNDA
Other - Middle Name:GAIL
Other - Last Name:KITTRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:503 RICHEY PL
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3644
Mailing Address - Country:US
Mailing Address - Phone:770-632-0803
Mailing Address - Fax:770-632-0803
Practice Address - Street 1:503 RICHEY PL
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3644
Practice Address - Country:US
Practice Address - Phone:770-632-0803
Practice Address - Fax:770-632-0803
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0014292251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics