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NPI Code Detail

MEDICARE: DR. SCOTT WALTER BRODNAX CHIROPRACTOR

MEDICARE:  DR. SCOTT WALTER BRODNAX  CHIROPRACTOR
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
1111N00000XChiropractor842SC

General Provider Information

NPI Number : 1922006634
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT WALTER BRODNAX CHIROPRACTOR
Provider Business Mailing Address
First Line : 225 CHURCH ST
Second Line :
City : CLOVER
State : SC
Zip : 29710-1008
Country : US
Telephone Number : 803-222-2323
Fax Number :
Provider Business Practice Location Address
First Line : 225 CHURCH ST
Second Line :
City : CLOVER
State : SC
Zip : 29710-1008
Country : US
Telephone Number : 803-222-2323
Fax Number : 803-222-2323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 10/09/2007

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Directions to “ DR. SCOTT WALTER BRODNAX CHIROPRACTOR” Practice Location

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