Provider Demographics
NPI:1063398782
Name:FITCH, TROY MARTIN SR (LMBT)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:MARTIN
Last Name:FITCH
Suffix:SR
Gender:M
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6984 JOSHUAS WAY
Mailing Address - Street 2:
Mailing Address - City:SIMS
Mailing Address - State:NC
Mailing Address - Zip Code:27880-9286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6984 JOSHUAS WAY
Practice Address - Street 2:
Practice Address - City:SIMS
Practice Address - State:NC
Practice Address - Zip Code:27880-9286
Practice Address - Country:US
Practice Address - Phone:252-620-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21979225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist