Provider Demographics
NPI:1861800237
Name:BYRON, JOSEPH III (LAC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:BYRON
Suffix:III
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 AUGUSTA HWY
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-1915
Mailing Address - Country:US
Mailing Address - Phone:803-422-0545
Mailing Address - Fax:
Practice Address - Street 1:1812 AUGUSTA HWY
Practice Address - Street 2:SUITE 1A
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-1915
Practice Address - Country:US
Practice Address - Phone:803-422-0545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCACUP224171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist