Provider Demographics
NPI:1124329438
Name:SCOTT GARR D.C. P.C.
Entity type:Organization
Organization Name:SCOTT GARR D.C. P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GARR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-721-9080
Mailing Address - Street 1:3487 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-5674
Mailing Address - Country:US
Mailing Address - Phone:406-721-9080
Mailing Address - Fax:406-721-9008
Practice Address - Street 1:3487 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-5674
Practice Address - Country:US
Practice Address - Phone:406-721-9080
Practice Address - Fax:406-721-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT159763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTM000004021Medicare PIN