Provider Demographics
NPI:1285922948
Name:SCOTT CHIROPRACTIC FORT COLLINS P.C.
Entity type:Organization
Organization Name:SCOTT CHIROPRACTIC FORT COLLINS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-482-1175
Mailing Address - Street 1:5125 S COLLEGE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3959
Mailing Address - Country:US
Mailing Address - Phone:970-482-1175
Mailing Address - Fax:970-372-6459
Practice Address - Street 1:5125 S COLLEGE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3959
Practice Address - Country:US
Practice Address - Phone:970-482-1175
Practice Address - Fax:970-372-6459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6329261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center