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General NPI Number Information
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NPI Number | 1417373747
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Entity Type | Organization
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Legal Business Name | GREG SCOTT DC LLC
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 10100 W 87TH STREET PARKWAY STE 320
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City | OVERLAND PARK
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State | KS
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Zip | 66212-4628
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Country | US
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Telephone | 913-701-6708
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Fax |
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Provider Business Mailing Address
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Address Line | 10100 W 87TH STREET PARKWAY STE 320
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City | OVERLAND PARK
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State | KS
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Zip | 66212-4628
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Country | US
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Telephone | 913-701-6708
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREG MICHAEL SCOTT
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Credential | DC, MS
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Telephone | 913-701-6708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 01-05573
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01-05573
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License Number State | KS
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