Organization
SOUTHEASTERN ORTHOPAEDICS
Active
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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