Provider Demographics
NPI:1902454507
Name:SOUTHEASTERN MOTOR AND SENSORY SPECIALISTS
Entity Type:Organization
Organization Name:SOUTHEASTERN MOTOR AND SENSORY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-748-0258
Mailing Address - Street 1:3530 BOONE TRL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-2189
Mailing Address - Country:US
Mailing Address - Phone:910-748-0258
Mailing Address - Fax:910-745-8405
Practice Address - Street 1:3530 BOONE TRL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-2189
Practice Address - Country:US
Practice Address - Phone:910-748-0258
Practice Address - Fax:910-745-8405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty