Provider Demographics
NPI:1235301565
Name:DELAY, PEGGY MEENTS (LAC)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:MEENTS
Last Name:DELAY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2427 E DUST DEVIL DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-5221
Mailing Address - Country:US
Mailing Address - Phone:480-648-7782
Mailing Address - Fax:
Practice Address - Street 1:1727 E BELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-2800
Practice Address - Country:US
Practice Address - Phone:480-648-7782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ441171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist