Provider Demographics
NPI:1922806660
Name:GARCIA, ALEX (LMT)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17765 W BRIDGER ST
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-1701
Mailing Address - Country:US
Mailing Address - Phone:505-414-2488
Mailing Address - Fax:
Practice Address - Street 1:17765 W BRIDGER ST
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-1701
Practice Address - Country:US
Practice Address - Phone:505-414-2488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-28759225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist