Provider Demographics
NPI:1548827280
Name:SMITH, ALEXANDER CHRISTOPHER (DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:CHRISTOPHER
Last Name:SMITH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 UNITED WAY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4970
Mailing Address - Country:US
Mailing Address - Phone:541-773-2999
Mailing Address - Fax:541-773-1874
Practice Address - Street 1:1911 UNITED WAY
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4970
Practice Address - Country:US
Practice Address - Phone:541-773-2999
Practice Address - Fax:541-773-1874
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist