Provider Demographics
NPI:1730872516
Name:ADAMS, ALEXIS (DPT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:DUDENHEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8059 MITCHELL LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-6821
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1575 HIGHWAY 34 E STE B
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2401
Practice Address - Country:US
Practice Address - Phone:770-683-5042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT016627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPT016627OtherSTATE LICENSE