Provider Demographics
NPI:1487716726
Name:GAUER, SCOTT PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:PAUL
Last Name:GAUER
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 1:1706 EAST TENTH STREET
Mailing Address - Street 2:GAUER CHIROPRACTIC CLINIC
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336
Mailing Address - Country:US
Mailing Address - Phone:320-864-3196
Mailing Address - Fax:320-864-3197
Practice Address - Street 1:1706 EAST TENTH STREET
Practice Address - Street 2:GAUER CHIROPRACTIC CLINIC
Practice Address - City:GLENCOE
Practice Address - State:MN
Practice Address - Zip Code:55336
Practice Address - Country:US
Practice Address - Phone:320-864-3196
Practice Address - Fax:320-864-3197
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
30701128OtherPRIME WEST
76796OtherFIRST HEALTH
MN3D442GAOtherBCBS
MN230272OtherCHIROPRACTIC CARE OF MINN
MN040528100Medicaid
MN040528100Medicaid
30701128OtherPRIME WEST