Provider Demographics
NPI:1871609123
Name:VARGO, ALEXANDER JR (PT)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:VARGO
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 EXECUTIVE PKWY
Mailing Address - Street 2:SUITE 128
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1326
Mailing Address - Country:US
Mailing Address - Phone:419-537-0764
Mailing Address - Fax:419-537-0948
Practice Address - Street 1:3150 DUSTIN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4362
Practice Address - Country:US
Practice Address - Phone:419-697-8000
Practice Address - Fax:419-697-9495
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT01399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist