Healthcare Provider Details

I. General information

NPI: 1699684852
Provider Name (Legal Business Name): MARY CATHERINE LOVICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 STAMPER RD STE 201
FAYETTEVILLE NC
28303-4100
US

IV. Provider business mailing address

806 STAMPER RD STE 201
FAYETTEVILLE NC
28303-4100
US

V. Phone/Fax

Practice location:
  • Phone: 910-818-2513
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number23601
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: