Provider Demographics
NPI:1548785793
Name:TEMPLETON, BYRON DANE (LAC)
Entity Type:Individual
Prefix:
First Name:BYRON
Middle Name:DANE
Last Name:TEMPLETON
Suffix:
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 1:102 S KANAWHA ST
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-5615
Mailing Address - Country:US
Mailing Address - Phone:304-890-8020
Mailing Address - Fax:
Practice Address - Street 1:102 S KANAWHA ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-5615
Practice Address - Country:US
Practice Address - Phone:304-890-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV96237171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist