Organization
SOUTHEASTERN ORTHOPAEDICS
Active
Other names
Southeastern Hand and Occupational Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL SCOTT MCMAHAN (ADMINISTRATOR)
(704) 866-8976
Entity
Organization
Contact information
Practice address
760 N NEW HOPE RD, SUITE A, GASTONIA, NC 28054
(704) 866-8976
(704) 866-8680
Mailing address
760 N NEW HOPE RD, SUITE A, GASTONIA, NC 28054
(704) 866-8976
(704) 866-8680
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
320
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014C3
BCBS INDIVIDUAL
NC
Enumeration date
05/19/2006
Last updated
08/22/2020
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