MEDICARE: PEGGY MEENTS DELAY 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	441	AZ

General Provider Information

NPI Number	:	1235301565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY MEENTS DELAY LAC

Provider Business Mailing Address
First Line	:	2427 E DUST DEVIL DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-5221
Country	:	US
Telephone Number	:	480-648-7782
Fax Number	:

Provider Business Practice Location Address
First Line	:	1727 E BELL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-2800
Country	:	US
Telephone Number	:	480-648-7782
Fax Number	:

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

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	03/26/2008

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Directions to “ PEGGY MEENTS DELAY LAC” Practice Location

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