Provider Demographics
NPI:1417833997
Name:ZICH, ALEXA MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:MARIE
Last Name:ZICH
Suffix:
Gender:F
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 1:375 S SANGA RD
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4813
Mailing Address - Country:US
Mailing Address - Phone:901-604-4487
Mailing Address - Fax:
Practice Address - Street 1:13540 W CAMINO DEL SOL STE 6
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4435
Practice Address - Country:US
Practice Address - Phone:623-566-5013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT5697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist