Provider Demographics
NPI:1285692335
Name:KLINE, SCOTT M (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:KLINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CHESTNUT ST
Mailing Address - Street 2:BACK ON TRACK CHIROPRACTIC
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-5429
Mailing Address - Country:US
Mailing Address - Phone:781-718-1151
Mailing Address - Fax:978-548-4379
Practice Address - Street 1:15 CHESTNUT ST
Practice Address - Street 2:BACK ON TRACK CHIROPRACTIC
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960
Practice Address - Country:US
Practice Address - Phone:781-718-1151
Practice Address - Fax:978-548-4379
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45829Medicare ID - Type Unspecified