| NPI | 1336946011 |
|---|---|
| Doing Business As | LAKE HICKORY MUAY THAI LLC |
| Entity Type | Organization |
| Authorized Contact | JENNIFER W SMITH Accountant 704-502-7405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-02-28 |
| Last Update Date | 2025-02-28 |