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Individual
JASON ALEXANDER
Active
Individual
JASON ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017559
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101369975-0003
—
PA
01
—
1447287867
BRAVO
PA
01
—
2425609000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
06/28/2006
Last updated
12/14/2011
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