MEDICARE: MR. WILLIAM GRAY LEHAN JR. LBMT

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	20205	NC

General Provider Information

NPI Number	:	1801746359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM GRAY LEHAN JR. LBMT

Provider Business Mailing Address
First Line	:	6907 BIRDSONG LN
Second Line	:
City	:	WAXHAW
State	:	NC
Zip	:	28173-7407
Country	:	US
Telephone Number	:	704-771-2774
Fax Number	:

Provider Business Practice Location Address
First Line	:	5910 WAXHAW HIGHWAY SUITE B
Second Line	:
City	:	MINERAL SPRINGS
State	:	NC
Zip	:	28108
Country	:	US
Telephone Number	:	704-771-2774
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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