Provider Demographics
NPI:1255145694
Name:CONKLIN, ALEXANDER (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:CONKLIN
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 1:27435 DETROIT RD APT F9
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2266
Mailing Address - Country:US
Mailing Address - Phone:440-935-4683
Mailing Address - Fax:
Practice Address - Street 1:5595 TRANSPORTATION BLVD STE 220
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-5359
Practice Address - Country:US
Practice Address - Phone:216-518-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT021522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist