Provider Demographics
NPI:1194267732
Name:SCOTT, KENYA (DC)
Entity type:Individual
Prefix:DR
First Name:KENYA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6941 N TRENHOLM RD STE O204
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-1733
Mailing Address - Country:US
Mailing Address - Phone:803-542-9589
Mailing Address - Fax:
Practice Address - Street 1:6941 N TRENHOLM RD STE O204
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206-1733
Practice Address - Country:US
Practice Address - Phone:803-542-9589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDC .4189 DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor