Provider Demographics
NPI:1730736703
Name:DUROCHER, ALEXANDRA
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:DUROCHER
Suffix:
Gender:F
Credentials:
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 284
Mailing Address - Street 2:
Mailing Address - City:WEST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02576-0284
Mailing Address - Country:US
Mailing Address - Phone:774-678-4041
Mailing Address - Fax:
Practice Address - Street 1:2360 CRANBERRY HWY
Practice Address - Street 2:
Practice Address - City:WEST WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02576-1208
Practice Address - Country:US
Practice Address - Phone:774-678-4041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist