Healthcare Provider Details

I. General information

NPI: 1831129212
Provider Name (Legal Business Name): JOHN SCOTT URBAN III D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10595 STATE ROUTE 550
BARLOW OH
45712
US

IV. Provider business mailing address

PO BOX 235
BEVERLY OH
45715-0235
US

V. Phone/Fax

Practice location:
  • Phone: 740-678-2700
  • Fax: 740-678-2777
Mailing address:
  • Phone: 740-678-2700
  • Fax: 740-678-2777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2989
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: