Provider Demographics
NPI:1417241969
Name:MEYER, JAMES CARLTON (LMBT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CARLTON
Last Name:MEYER
Suffix:
Gender:M
Credentials:LMBT
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:CARLTON
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMBT
Mailing Address - Street 1:8001 BROOK VALLEY RUN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110
Mailing Address - Country:US
Mailing Address - Phone:704-604-1987
Mailing Address - Fax:
Practice Address - Street 1:8001 BROOK VALLEY RUN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-6347
Practice Address - Country:US
Practice Address - Phone:704-604-1987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6661225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist