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General NPI Number Information
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NPI Number | 1467566570
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Entity Type | Individual
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Provider Name | SCOT WILLIS MCCORMICK DC
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 3901 MARY ELIZA TRCE NW STE 201
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City | MARIETTA
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State | GA
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Zip | 30064-1096
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Country | US
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Telephone | 215-694-4831
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Fax |
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Provider Business Mailing Address
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Address Line | 900 GULF BLVD APT 202
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City | INDIAN ROCKS BEACH
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State | FL
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Zip | 33785-2726
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Country | US
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Telephone | 215-694-4831
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR011408
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License Number State | GA
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