Provider Demographics
NPI:1518667518
Name:CULP, VICKIE GAIL (LMBT)
Entity Type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:GAIL
Last Name:CULP
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 1:439 WESTWOOD SHOPPING CTR # 190
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1532
Mailing Address - Country:US
Mailing Address - Phone:703-599-8586
Mailing Address - Fax:
Practice Address - Street 1:251 KODIAK CIR
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3404
Practice Address - Country:US
Practice Address - Phone:703-599-8586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18827225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist