Provider Demographics
NPI:1851543201
Name:GAMES, PETER (L AC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:GAMES
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6003 OVERLAND RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-3073
Mailing Address - Country:US
Mailing Address - Phone:208-377-1455
Mailing Address - Fax:
Practice Address - Street 1:6003 OVERLAND RD
Practice Address - Street 2:SUITE 203
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-3073
Practice Address - Country:US
Practice Address - Phone:208-377-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDACU-222171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist