Provider Demographics
NPI:1790101467
Name:LECHTNER, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:LECHTNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 1ST AVE NW
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-6161
Mailing Address - Country:US
Mailing Address - Phone:828-312-5085
Mailing Address - Fax:
Practice Address - Street 1:260 1ST AVE NW
Practice Address - Street 2:SUITE 208
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-6161
Practice Address - Country:US
Practice Address - Phone:828-312-5085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9399225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist