Provider Demographics
NPI:1902476195
Name:TULINTSEFF, ALEXANDRA (DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:TULINTSEFF
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 1:1070 BERGESON DR
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56241-1252
Mailing Address - Country:US
Mailing Address - Phone:206-327-0421
Mailing Address - Fax:
Practice Address - Street 1:345 10TH AVE
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56241-1442
Practice Address - Country:US
Practice Address - Phone:206-327-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist