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NPI Code Detail

MEDICARE: ALEXANDRA LEE TUTTLE DPT

MEDICARE: ALEXANDRA LEE TUTTLE DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistP21820NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P21820OTHERNCPT LICENSE

General Provider Information

NPI Number : 1902515497
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA LEE TUTTLE DPT
Provider Business Mailing Address
First Line : PO BOX 5105
Second Line :
City : BELFAST
State : ME
Zip : 04915-5100
Country : US
Telephone Number : 252-726-1802
Fax Number : 252-726-1805
Provider Business Practice Location Address
First Line : 2000 BRABHAM AVE STE 100
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-0202
Country : US
Telephone Number : 910-332-3800
Fax Number : 910-251-0421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2022
Last Update Date : 09/08/2025

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