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General NPI Number Information
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NPI Number | 1134269251
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Entity Type | Individual
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Provider Name | SEEMA S DEVASTHALI PT
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2125 VALLEYGATE DR SUITE 101-A
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3657
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Country | US
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Telephone | 910-223-0729
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Fax | 910-223-0733
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Provider Business Mailing Address
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Address Line | PO BOX 53605
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-3605
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Country | US
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Telephone | 910-223-0729
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Fax | 910-223-0733
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4191
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License Number State | NC
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