Basic Information
Provider Information
NPI: 1497349310
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALEXANDER
FirstName: CADEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 14287 N 87TH ST STE 220
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852603698
CountryCode: US
TelephoneNumber: 6023298250
FaxNumber: 6023298250
Practice Location
Address1: 5040 N 15TH AVE STE 401
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850153332
CountryCode: US
TelephoneNumber: 6022850949
FaxNumber: 6022850052
Other Information
ProviderEnumerationDate: 02/22/2021
LastUpdateDate: 02/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X AZY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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