Provider Demographics
NPI:1750848248
Name:LYMPHEDEMA CENTER OF ASHEVILLE, LLC
Entity Type:Organization
Organization Name:LYMPHEDEMA CENTER OF ASHEVILLE, LLC
Other - Org Name:LYMPHEDEMA CENTER OF ASHEVILLE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OT, CLT
Authorized Official - Phone:828-505-0811
Mailing Address - Street 1:60 LIVINGSTON STREET
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801
Mailing Address - Country:US
Mailing Address - Phone:828-505-0811
Mailing Address - Fax:828-505-1386
Practice Address - Street 1:60 LIVINGSTON STREET
Practice Address - Street 2:SUITE 400
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801
Practice Address - Country:US
Practice Address - Phone:828-505-0811
Practice Address - Fax:828-505-1386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty