Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Norman Muay Thai LLC

Organization Community/Behavioral Health Agency · NPI 1336946011

Lake Norman Muay Thai LLC is a Community/Behavioral Health Agency in Mooresville, North Carolina. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

107 Commons Dr Ste I
Mooresville, NC 28117-9262
Phone: (704) 657-1080
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X

Record details

NPI number1336946011
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Smith — Accountant · (704) 502-7405
Other names Lake Hickory Muay Thai Llc
NPI enumeratedFebruary 28, 2025
Last updated in NPPESFebruary 28, 2025
Certification dateFebruary 28, 2025
Mailing address207 Hickory Hill Rd, Mooresville, NC 28117-8215

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