MEDICARE: DR. SCOTT ANDREW MOORING DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4451	MN

General Provider Information

NPI Number	:	1346353612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ANDREW MOORING DC

Provider Business Mailing Address
First Line	:	1525 LIVINGSTON AVE
Second Line	:
City	:	WEST SAINT PAUL
State	:	MN
Zip	:	55118-3411
Country	:	US
Telephone Number	:	651-455-5264
Fax Number	:	651-455-1172

Provider Business Practice Location Address
First Line	:	1525 LIVINGSTON AVE
Second Line	:
City	:	WEST SAINT PAUL
State	:	MN
Zip	:	55118-3411
Country	:	US
Telephone Number	:	651-455-5264
Fax Number	:	651-455-1172

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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