Healthcare Provider Details

I. General information

NPI: 1467568402
Provider Name (Legal Business Name): SCOTT E OKARSKI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CLYDE MORRIS BLVD SUITE 120
ORMOND BEACH FL
32174-8181
US

IV. Provider business mailing address

305 CLYDE MORRIS BLVD SUITE 120
ORMOND BEACH FL
32174-8181
US

V. Phone/Fax

Practice location:
  • Phone: 386-672-6642
  • Fax: 386-672-7288
Mailing address:
  • Phone: 386-672-6642
  • Fax: 386-672-7288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH7348
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: