Healthcare Provider Details

I. General information

NPI: 1801379318
Provider Name (Legal Business Name): NATITIA PAUGH L.AC., LMBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TISHA PAUGH L.AC., LMBT

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 N MAIN ST
OAKBORO NC
28129-9332
US

IV. Provider business mailing address

6305A DRYE HILL RD
STANFIELD NC
28163-5500
US

V. Phone/Fax

Practice location:
  • Phone: 704-318-5079
  • Fax:
Mailing address:
  • Phone: 704-318-5079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number03388
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1011
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: