Provider Demographics
NPI:1245598184
Name:KILLIAN, JOYCE (LMBT)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:KILLIAN
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 SANFORD DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-2573
Mailing Address - Country:US
Mailing Address - Phone:828-430-7600
Mailing Address - Fax:828-422-7616
Practice Address - Street 1:317 SANFORD DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-2573
Practice Address - Country:US
Practice Address - Phone:828-430-7600
Practice Address - Fax:828-433-7616
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-29
Last Update Date:2012-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0546225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist