Individual
OSEMWEGIE EGHIDEMWIVBIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMBT, AAS, PT
Contact information
Practice address
100 PAVILION WAY, SOUTHERN PINES, NC 28387-4559
(910) 315-0402
Mailing address
100 PAVILION WAY, SOUTHERN PINES, NC 28387-4559
(919) 520-9658
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17137
NC
Other
Enumeration date
07/09/2021
Last updated
01/28/2022
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