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General NPI Number Information
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NPI Number | 1093300295
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Entity Type | Individual
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Provider Name | CHRISTOPHER ALLEN SCOTT CPHT
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Gender | Male
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Dates
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Enumeration Date | 03/09/2021
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 45600 UTICA PARK BLVD
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City | UTICA
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State | MI
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Zip | 48315-5917
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Country | US
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Telephone | 586-739-5472
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Fax | 586-739-5489
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Provider Business Mailing Address
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Address Line | 45189 DEEPWOOD CT
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48317-4982
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Country | US
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Telephone | 586-604-2313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 5303018491
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License Number State | MI
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