Provider Demographics
NPI:1699989186
Name:DR. SCOTT A CARPENTER, DC
Entity type:Organization
Organization Name:DR. SCOTT A CARPENTER, DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-884-5560
Mailing Address - Street 1:1530 STATE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4955
Mailing Address - Country:US
Mailing Address - Phone:563-344-8785
Mailing Address - Fax:563-344-8785
Practice Address - Street 1:1530 STATE ST STE 2
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4955
Practice Address - Country:US
Practice Address - Phone:563-344-8785
Practice Address - Fax:563-344-8785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0249813Medicaid
IA20955OtherBCBS
IAU81130Medicare UPIN
IA0249813Medicaid