Individual
ALEXANDRA TUCKER BOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
514 S BROWN ST, SPRINGFIELD, TN 37172-2937
(615) 988-4552
(615) 382-0501
Mailing address
PO BOX 1637, SPRINGFIELD, TN 37172-1637
(615) 988-4552
(615) 382-0501
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
12957
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12957
STATE LICENSE
TN
Enumeration date
12/02/2020
Last updated
12/11/2020
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