Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexandra Deptula Manurung, MS, LAT, ATC, PTA

Individual provider Athletic Trainer · NPI 1376956318

Alexandra Deptula Manurung, MS, LAT, ATC, PTA is an Athletic Trainer in Rockville, Maryland. Licensed in Maryland. Registered with an NPI since 2014.

Licensed in
MD
In the registry since
2014
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

715 Carter Rd
Rockville, MD 20852-1006
Phone: (410) 340-1046
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence A4337 (MD)
Athletic Trainer Taxonomy 2255A2300X · Licence A00208 (MD)

Record details

NPI number1376956318
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , LAT , ATC , PTA
Sole proprietorNo
NPI enumeratedJune 7, 2014
Last updated in NPPESApril 15, 2021
Certification dateApril 15, 2021

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