Healthcare Provider Details

I. General information

NPI: 1316237753
Provider Name (Legal Business Name): SCOTT HOAR D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 02/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 GATEWAY BLVD UNIT 104
BOYNTON BEACH FL
33426-8370
US

IV. Provider business mailing address

1014 GATEWAY BLVD UNIT 104
BOYNTON BEACH FL
33426-8370
US

V. Phone/Fax

Practice location:
  • Phone: 561-877-1680
  • Fax:
Mailing address:
  • Phone: 561-877-1680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10276
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: