Individual
AMANDA HIBBITTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED MASSAGE THE
Contact information
Practice address
364 WILLIAMSON RD, MOORESVILLE, NC 28117-5916
(336) 466-0195
Mailing address
PO BOX 5036, MOORESVILLE, NC 28117-5036
(336) 466-0195
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
09069
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09069
LICENSE/CERTIFICATION
NC
Enumeration date
07/25/2022
Last updated
07/25/2022
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