| NPI | 1689808420 |
|---|---|
| Former Name | ALEXIS MICKOWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 039873) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 7911) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2025-08-11 |