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Alexandra Bialousow

Physical Therapy Assistant in Myrtle Beach, SC. Individual provider (NPI-1).

NPI number1295564516
StatusActive
Last updated in NPPESJul 26, 2024

Details

NPI
1295564516
Entity type
Individual (NPI-1)
Name
Alexandra Bialousow
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 26, 2024
Certification date
Jul 26, 2024
Last updated
Jul 26, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistant4597SCYes

Practice location

3736 Robert Grissom Pkwy
Myrtle Beach, SC 29577-6405

Phone 800-304-7152

Mailing address

3736 Robert Grissom Pkwy
Myrtle Beach, SC 29577-6405

Phone 843-602-0289

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