Organization
ACTIVE ASHEVILLE INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN PAUL CLANCY LMBT (OWNER)
(828) 333-1239
Entity
Organization
Contact information
Practice address
370 N LOUISIANA AVE STE G4, ASHEVILLE, NC 28806-3658
(828) 333-1239
Mailing address
370 N LOUISIANA AVE STE G4, ASHEVILLE, NC 28806-3658
(828) 333-1239
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14063
NC
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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