Provider Demographics
NPI:1730988817
Name:ALEX PT
Entity type:Organization
Organization Name:ALEX PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:651-283-6894
Mailing Address - Street 1:591 NORTHSIDE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-5578
Mailing Address - Country:US
Mailing Address - Phone:320-445-0100
Mailing Address - Fax:320-445-0098
Practice Address - Street 1:591 NORTHSIDE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-5578
Practice Address - Country:US
Practice Address - Phone:320-445-0100
Practice Address - Fax:320-445-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy