Individual
ALEXANDER T MISCANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 MAIN ST, STE 8, RIVERTON, NJ 08077-1400
(856) 360-5630
Mailing address
600 MAIN ST STE 8, RIVERTON, NJ 08077-1400
(856) 360-5630
(610) 933-3376
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01942800
NJ
225100000X
Physical Therapist
PT028019
PA
Other
Enumeration date
09/03/2019
Last updated
09/03/2021
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