Provider Demographics
NPI:1710594270
Name:MCMEEKIN, ALEXANDER MATTHEW (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:MATTHEW
Last Name:MCMEEKIN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 OLD TROLLEY RD STE D
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-5685
Mailing Address - Country:US
Mailing Address - Phone:843-871-3522
Mailing Address - Fax:
Practice Address - Street 1:440 OLD TROLLEY RD STE D
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-5685
Practice Address - Country:US
Practice Address - Phone:843-871-3522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC10300OtherPT LICENSE