Healthcare Provider Details

I. General information

NPI: 1457414823
Provider Name (Legal Business Name): TREMAYNE T THURMAN AS, MRS, OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5860 YADKIN RD
FAYETTEVILLE NC
28303-2668
US

IV. Provider business mailing address

5860 YADKIN RD
FAYETTEVILLE NC
28303-2668
US

V. Phone/Fax

Practice location:
  • Phone: 910-401-9210
  • Fax: 910-401-9211
Mailing address:
  • Phone: 910-401-9210
  • Fax: 910-401-9211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number5574
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: