Healthcare Provider Details

I. General information

NPI: 1841243524
Provider Name (Legal Business Name): RYAN MICHAEL SCOTTING D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 FORESIGHT CIR UNIT D
GRAND JUNCTION CO
81505-1007
US

IV. Provider business mailing address

660 CORDIAL CT
GRAND JUNCTION CO
81506-8503
US

V. Phone/Fax

Practice location:
  • Phone: 970-242-9001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4644
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: