Healthcare Provider Details

I. General information

NPI: 1225954910
Provider Name (Legal Business Name): BUTTERFLY MASSAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

994 COPPERFIELD BLVD NE STE 6
CONCORD NC
28025-2433
US

IV. Provider business mailing address

994 COPPERFIELD BLVD NE STE 6
CONCORD NC
28025-2433
US

V. Phone/Fax

Practice location:
  • Phone: 704-565-0262
  • Fax:
Mailing address:
  • Phone: 704-565-0262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHARMELEL ASE LEIANDER YOUNG
Title or Position: OWNER
Credential: LMBT
Phone: 704-565-0262