Provider Demographics
NPI:1588069199
Name:PREYER, ALEXA ANGELINA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:ANGELINA
Last Name:PREYER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:ANGELINA
Other - Last Name:EBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-8684
Practice Address - Street 1:5370 CAMPBELLTON FAIRBURN RD
Practice Address - Street 2:STE 530
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-2296
Practice Address - Country:US
Practice Address - Phone:678-666-4146
Practice Address - Fax:678-666-4148
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29465225100000X
GAPT011736225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist