MEDICARE: MR. JOSEPH BYRON III L.AC

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	ACUP224	SC

General Provider Information

NPI Number	:	1861800237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH BYRON III L.AC

Provider Business Mailing Address
First Line	:	1812 AUGUSTA HWY
Second Line	:	SUITE 1A
City	:	LEXINGTON
State	:	SC
Zip	:	29072-1915
Country	:	US
Telephone Number	:	803-422-0545
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 AUGUSTA HWY
Second Line	:	SUITE 1A
City	:	LEXINGTON
State	:	SC
Zip	:	29072-1915
Country	:	US
Telephone Number	:	803-422-0545
Fax Number	:

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

Provider Enumeration Date	:	07/29/2014
Last Update Date	:	06/22/2016

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