Basic Information
| Provider Information | |||||||||
| NPI: | 1942511670 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | BRENT | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 US HIGHWAY 41A S | ||||||||
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| City: | PROVIDENCE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 424502142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2706350271 | ||||||||
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| Practice Location | |||||||||
| Address1: | 509 N CARRIER ST | ||||||||
| Address2: | |||||||||
| City: | MORGANFIELD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 424371201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2703893513 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2010 | ||||||||
| LastUpdateDate: | 06/28/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | A02648 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.