Provider Demographics
NPI:1639761554
Name:ALFORD, DANIEL ROBERT
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROBERT
Last Name:ALFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7078 BRIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-9095
Mailing Address - Country:US
Mailing Address - Phone:336-410-1142
Mailing Address - Fax:
Practice Address - Street 1:313 NC HIGHWAY 801 N
Practice Address - Street 2:
Practice Address - City:BERMUDA RUN
Practice Address - State:NC
Practice Address - Zip Code:27006-7905
Practice Address - Country:US
Practice Address - Phone:336-716-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14678225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist