Healthcare Provider Details

I. General information

NPI: 1275614463
Provider Name (Legal Business Name): GREGORY SCOTT ASH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 E SUPERIOR ST FISHER CHIROPRACTIC CLINIC
DULUTH MN
55802-2217
US

IV. Provider business mailing address

1510 TRIGGS AVE
DULUTH MN
55811-2742
US

V. Phone/Fax

Practice location:
  • Phone: 218-728-3639
  • Fax: 218-728-2603
Mailing address:
  • Phone: 218-728-1049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1809
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: