Individual
EUGENE W DESLAURIERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1513 N HOWE ST, SUITE 4, SOUTHPORT, NC 28461-2770
(910) 454-8030
Mailing address
3300 BOUGAINVILLE WAY, WILMINGTON, NC 28409-2503
(910) 454-8030
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
3904
NC
225100000X
Physical Therapist
Primary
3904
NC
Other
Enumeration date
04/11/2007
Last updated
08/11/2016
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