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General NPI Number Information
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NPI Number | 1790170876
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Entity Type | Organization
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Legal Business Name | DR BRIAN SCOTT LLC
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 1658 PLEASURE HOUSE RD #104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-4051
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Country | US
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Telephone | 757-337-5156
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Fax |
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Provider Business Mailing Address
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Address Line | 1658 PLEASURE HOUSE RD #104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-4051
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Country | US
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Telephone | 757-337-5156
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. BRIAN W SCOTT
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Credential | DC
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Telephone | 757-337-5156
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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 | 0104557239
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License Number State | VA
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