Provider Demographics
NPI:1982026035
Name:COLLINS, ALEXANDER LOUIS (LMT)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:LOUIS
Last Name:COLLINS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 D AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-4921
Mailing Address - Country:US
Mailing Address - Phone:319-210-7866
Mailing Address - Fax:
Practice Address - Street 1:2322 D AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-4921
Practice Address - Country:US
Practice Address - Phone:319-210-7866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005334225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist