MEDICARE: PAM BUTZ L.AC., MSOM

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	0121-000750	VA

General Provider Information

NPI Number	:	1730510900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAM BUTZ L.AC., MSOM

Provider Business Mailing Address
First Line	:	144 SILVER MAPLE LN
Second Line	:
City	:	PILOT
State	:	VA
Zip	:	24138-1703
Country	:	US
Telephone Number	:	540-651-2682
Fax Number	:	540-651-2682

Provider Business Practice Location Address
First Line	:	144 SILVER MAPLE LN
Second Line	:
City	:	PILOT
State	:	VA
Zip	:	24138-1703
Country	:	US
Telephone Number	:	540-651-2682
Fax Number	:	540-651-2682

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

Provider Enumeration Date	:	12/12/2013
Last Update Date	:	09/22/2014

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Directions to “ PAM BUTZ L.AC., MSOM” Practice Location

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