Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER F NICOSIA PT (PHYSICAL THERAPIST)
(910) 738-4554
Entity
Organization
Contact information
Practice address
4895 FAYETTEVILLE RD, LUMBERTON, NC 28358-2162
(910) 738-4554
(910) 739-4027
Mailing address
1031 GATESVILLE DR, HOPE MILLS, NC 28348-8001
(910) 426-9346
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
8799
NC
Other
Enumeration date
06/01/2007
Last updated
08/22/2020
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