Provider Demographics
NPI:1811514920
Name:LEFEBVRE, STEPHEN ANTHONY (LMT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ANTHONY
Last Name:LEFEBVRE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:958 PALMER RD
Mailing Address - Street 2:
Mailing Address - City:MILL SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:28756-7603
Mailing Address - Country:US
Mailing Address - Phone:860-857-7282
Mailing Address - Fax:
Practice Address - Street 1:3754 BREVARD RD STE 105
Practice Address - Street 2:
Practice Address - City:HORSE SHOE
Practice Address - State:NC
Practice Address - Zip Code:28742-8809
Practice Address - Country:US
Practice Address - Phone:828-606-0258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15918225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist