Provider Demographics
NPI:1548868763
Name:MCLAUGHLIN, ALEXANDER KENNETH
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:KENNETH
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 SUMMIT HOUSE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-6550
Mailing Address - Country:US
Mailing Address - Phone:484-862-7471
Mailing Address - Fax:
Practice Address - Street 1:184 SUMMIT HOUSE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-6550
Practice Address - Country:US
Practice Address - Phone:484-862-7471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG0122995225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist