Provider Demographics
NPI:1144655549
Name:GRIFFIN, ALEXIS (PT, DPT, SCS, ATC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PT, DPT, SCS, ATC
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:ROSEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 ACADEMY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-1870
Mailing Address - Country:US
Mailing Address - Phone:563-554-7413
Mailing Address - Fax:
Practice Address - Street 1:200 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-1870
Practice Address - Country:US
Practice Address - Phone:563-554-7413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0143732251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports