Provider Demographics
NPI:1003570938
Name:WHEELWRIGHT, ALEXANDER THOREAU (DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:THOREAU
Last Name:WHEELWRIGHT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 US ROUTE 1 UNIT A
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1309
Mailing Address - Country:US
Mailing Address - Phone:207-781-2741
Mailing Address - Fax:
Practice Address - Street 1:325 US ROUTE 1 UNIT A
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1309
Practice Address - Country:US
Practice Address - Phone:207-781-2741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT6059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist