Individual
OTHA LEROY SWEPSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3941B MARKET ST, WILMINGTON, NC 28403-1403
(910) 599-7813
Mailing address
17 N 31ST ST, WILMINGTON, NC 28405-3109
(910) 599-7813
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13004
NC
Other
Enumeration date
10/27/2016
Last updated
10/27/2016
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