Provider Demographics
NPI:1215269998
Name:ALCOY, DEXTER (PT,DPT)
Entity type:Individual
Prefix:
First Name:DEXTER
Middle Name:
Last Name:ALCOY
Suffix:
Gender:M
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 WEBBER WAY
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-4375
Mailing Address - Country:US
Mailing Address - Phone:619-418-7676
Mailing Address - Fax:
Practice Address - Street 1:1835 WEBBER WAY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-4375
Practice Address - Country:US
Practice Address - Phone:619-418-7676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist