Provider Demographics
NPI:1831890136
Name:KNORR, ALEXANDRA (LMT)
Entity type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:
Last Name:KNORR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 WEXFORD BAYNE RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8748
Mailing Address - Country:US
Mailing Address - Phone:724-940-3900
Mailing Address - Fax:888-299-2936
Practice Address - Street 1:141 WEXFORD BAYNE RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8748
Practice Address - Country:US
Practice Address - Phone:724-940-3900
Practice Address - Fax:888-299-2936
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG011036225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist