MEDICARE: MR. PETER WEST 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	SC054	SC

General Provider Information

NPI Number	:	1578001517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PETER WEST LAC

Provider Business Mailing Address
First Line	:	30 NEW ORLEANS RD
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29928-4715
Country	:	US
Telephone Number	:	843-683-4584
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 NEW ORLEANS RD
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29928-4715
Country	:	US
Telephone Number	:	843-683-4584
Fax Number	:

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

Provider Enumeration Date	:	02/10/2017
Last Update Date	:	02/10/2017

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Directions to “ MR. PETER WEST LAC” Practice Location

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