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General NPI Number Information
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NPI Number | 1770322653
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Entity Type | Organization
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Legal Business Name | DR. SHANE SCOTT, SC CHIROPRACTIC INC.
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Dates
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Enumeration Date | 05/21/2024
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 13071 BROOKHURST ST STE 110
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1047
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Country | US
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Telephone | 714-839-8144
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Fax | 714-908-2328
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Provider Business Mailing Address
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Address Line | 13071 BROOKHURST ST STE 110
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1047
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Country | US
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Telephone | 714-839-8144
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Fax | 714-908-2328
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHANE MARK SCOTT
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Credential | DC,
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Telephone | 714-585-3000
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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 |
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License Number State |
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