Provider Demographics
NPI:1962434548
Name:CARPENTER, SCOTT (DC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:CARPENTER
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 1:1189 W SEAGULL DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-7546
Mailing Address - Country:US
Mailing Address - Phone:480-310-0226
Mailing Address - Fax:
Practice Address - Street 1:1520 W WARNER RD
Practice Address - Street 2:SUITE 108
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-7066
Practice Address - Country:US
Practice Address - Phone:480-932-6632
Practice Address - Fax:480-632-6634
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor