Provider Demographics
NPI:1598222499
Name:CORTRIGHT, EDWARD GREENFIELD III (LMBT)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:GREENFIELD
Last Name:CORTRIGHT
Suffix:III
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:PO BOX 1273
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-1273
Mailing Address - Country:US
Mailing Address - Phone:828-775-9174
Mailing Address - Fax:
Practice Address - Street 1:417 BILTMORE AVE # 5H2
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4501
Practice Address - Country:US
Practice Address - Phone:828-775-9174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16064225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty