Provider Demographics
NPI:1952179996
Name:WHITE, ALEXANDRIA VICTORIA (DPT)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:VICTORIA
Last Name:WHITE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 OFFICE PARK CIR STE 217
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2674
Mailing Address - Country:US
Mailing Address - Phone:205-263-2770
Mailing Address - Fax:205-263-0994
Practice Address - Street 1:183 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1496
Practice Address - Country:US
Practice Address - Phone:205-655-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH11611208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation