Provider Demographics
NPI:1447538434
Name:DURLAND, ALEXANDER NATHANIEL (DPT, CSCS)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:NATHANIEL
Last Name:DURLAND
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:ECU PHYSICIANS PHYSICAL THERAPY
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 HEART DRIVE
Practice Address - Street 2:ECU PHYSICIANS PHYSICAL THERAPY
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-8944
Practice Address - Country:US
Practice Address - Phone:252-695-6322
Practice Address - Fax:252-695-6321
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10882225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7212908Medicaid
NC1647AOtherBCBSNC
NCQ373320322Medicare PIN
NC1647AOtherBCBSNC