MEDICARE: ZACHARY WHITEMAN LMBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	22777	NC

General Provider Information

NPI Number	:	1497604284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY WHITEMAN LMBT

Provider Business Mailing Address
First Line	:	PO BOX 1114
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-1114
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21032 N MAIN ST
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-8434
Country	:	US
Telephone Number	:	828-280-2511
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2026
Last Update Date	:	01/24/2026

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