Provider Demographics
NPI:1861901183
Name:SAMS, ALEXIS LACEY (DPT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:LACEY
Last Name:SAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:LACEY
Other - Last Name:SPEARMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-373-7116
Practice Address - Street 1:3879 W ASHLEY CIR UNIT 700
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-9272
Practice Address - Country:US
Practice Address - Phone:843-628-0121
Practice Address - Fax:843-628-0124
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8881225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist