Healthcare Provider Details

I. General information

NPI: 1023525540
Provider Name (Legal Business Name): SCOTT TIMOTHY MCGRAW D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2018
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1246 32ND AVE N
SAINT CLOUD MN
56303-1649
US

IV. Provider business mailing address

1246 32ND AVE N
SAINT CLOUD MN
56303-1649
US

V. Phone/Fax

Practice location:
  • Phone: 320-230-8920
  • Fax:
Mailing address:
  • Phone: 320-230-8920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6454
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: