Provider Demographics
NPI:1154788800
Name:MUNTER, ALEXANDER (MSAT, LAT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:MUNTER
Suffix:
Gender:M
Credentials:MSAT, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S 4TH ST # 82
Mailing Address - Street 2:
Mailing Address - City:KLEMME
Mailing Address - State:IA
Mailing Address - Zip Code:50449-7713
Mailing Address - Country:US
Mailing Address - Phone:612-845-6300
Mailing Address - Fax:
Practice Address - Street 1:605 E J ST STE 200
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:IA
Practice Address - Zip Code:50436-1664
Practice Address - Country:US
Practice Address - Phone:641-585-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0793392255A2300X
VA01260020212255A2300X
MN27572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer