Healthcare Provider Details

I. General information

NPI: 1922922616
Provider Name (Legal Business Name): ANNA JUSTICE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 US HIGHWAY 301 S
SMITHFIELD NC
27577-9495
US

IV. Provider business mailing address

1286 THOMPSON RD APT G
FOUR OAKS NC
27524-8571
US

V. Phone/Fax

Practice location:
  • Phone: 919-710-9895
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number22646
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: