=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073750782
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JO ANN SCOTT CHIROPRACTIC, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2009
-----------------------------------------------------
Last Update Date | 01/16/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 30100 CROWN VALLEY PKWY SUITE 16
-----------------------------------------------------
City | LAGUNA NIGUEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92677-2041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-249-2720
-----------------------------------------------------
Fax | 949-249-1846
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30100 CROWN VALLEY PKWY SUITE 16
-----------------------------------------------------
City | LAGUNA NIGUEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92677-2041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-249-2720
-----------------------------------------------------
Fax | 949-249-1846
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JO ANN M SCOTT
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 949-249-2720
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC21541
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------