Provider Demographics
NPI:1831988542
Name:SIERRA, JAMES MACKENZIE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MACKENZIE
Last Name:SIERRA
Suffix:
Gender:
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HUNT CLUB LN APT F
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1591
Mailing Address - Country:US
Mailing Address - Phone:704-910-7004
Mailing Address - Fax:
Practice Address - Street 1:1300 SE MAYNARD RD STE 103A
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3602
Practice Address - Country:US
Practice Address - Phone:704-910-7004
Practice Address - Fax:704-910-7004
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11755225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist