National Provider Identifier
Alexis Lisa Mack, DPT
Alexis Lisa Mack, DPT is listed in the NPPES registry with a primary specialty of Physical Therapist in Tonawanda, NY and a listed phone number of (716) 862-0567.
Profile Overview
- NPI
- 1649845454
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- May 24, 2021
- Last Updated
- November 27, 2023
Practice Location
- 2540 Sheridan Dr
- Tonawanda, NY 14150-9410
Phone: (716) 862-0567
Mailing Address
- 6965 Goldfinch Ct
- North Tonawanda, NY 14120-1376
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1649845454
- Entity Type
- Individual
- Last Name
- Mack
- First Name
- Alexis
- Middle Name
- Lisa
- Name Prefix
- Miss
- Credential
- DPT
- Provider Other Last Name
- Peters
- Provider Other First Name
- Alexis
- Provider Other Middle Name
- Lisa
- Provider Other Credential Text
- DPT
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 6965 Goldfinch Ct
- Mailing City
- North Tonawanda
- Mailing State
- NY
- Mailing ZIP Code
- 14120-1376
- Mailing Country
- US
- Mailing Phone
- (716) 548-2930
- Practice Street Address
- 2540 Sheridan Dr
- Practice City
- Tonawanda
- Practice State
- NY
- Practice ZIP Code
- 14150-9410
- Practice Country
- US
- Practice Phone
- (716) 862-0567
- Enumeration Date
- May 24, 2021
- Last Updated
- November 27, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- November 27, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)