Provider Demographics
NPI:1316012313
Name:LARKINLMBT, LUCIAN CARDEN (LMBT)
Entity Type:Individual
Prefix:MR
First Name:LUCIAN
Middle Name:CARDEN
Last Name:LARKINLMBT
Suffix:
Gender:M
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 NOTTOWAY CT APT F
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4081
Mailing Address - Country:US
Mailing Address - Phone:919-877-0518
Mailing Address - Fax:
Practice Address - Street 1:6330 FALLS OF THE NEUSE RD.
Practice Address - Street 2:SUITE 102
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6810
Practice Address - Country:US
Practice Address - Phone:919-954-5031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC373225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist