MEDICARE: BETTY SHUFORD LAC

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	171100000X	Acupuncturist	119	SC

General Provider Information

NPI Number	:	1306629555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY SHUFORD LAC

Provider Business Mailing Address
First Line	:	364 S PINE ST STE B130
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29302-2651
Country	:	US
Telephone Number	:	864-580-6220
Fax Number	:

Provider Business Practice Location Address
First Line	:	364 S PINE ST STE B130
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29302-2651
Country	:	US
Telephone Number	:	864-580-6220
Fax Number	:

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

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	08/14/2023

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Directions to “ BETTY SHUFORD LAC” Practice Location

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