Provider Demographics
NPI:1891311478
Name:ALEY, WILLIAM DENNIS (LBMT NC 16516)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DENNIS
Last Name:ALEY
Suffix:
Gender:M
Credentials:LBMT NC 16516
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-4935
Mailing Address - Country:US
Mailing Address - Phone:252-721-4401
Mailing Address - Fax:
Practice Address - Street 1:401 N MARKET ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4935
Practice Address - Country:US
Practice Address - Phone:252-721-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16516225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist