Provider Demographics
NPI:1760538839
Name:WEST, SUSAN LYNNE (DIPL AC MTOM)
Entity Type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:LYNNE
Last Name:WEST
Suffix:
Gender:F
Credentials:DIPL AC MTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MILL FARM TRL
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-6404
Mailing Address - Country:US
Mailing Address - Phone:304-258-2676
Mailing Address - Fax:
Practice Address - Street 1:920 W WASHINGTON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-2800
Practice Address - Country:US
Practice Address - Phone:240-420-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00527171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist