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General NPI Number Information
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NPI Number | 1861792731
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Entity Type | Organization
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Legal Business Name | SCURLOCK CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 7689 S VIRGINIA ST SUITE Q
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City | RENO
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State | NV
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Zip | 89511-1148
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Country | US
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Telephone | 775-853-3343
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Fax | 775-853-0643
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Provider Business Mailing Address
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Address Line | 7689 S VIRGINIA ST SUITE Q
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City | RENO
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State | NV
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Zip | 89511-1148
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Country | US
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Telephone | 775-853-3343
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Fax | 775-853-0643
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/OWNER
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Name | DR. KRISTEN KORI SCURLOCK
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Credential | D.C.
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Telephone | 775-853-3343
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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 | B01058
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License Number State | NV
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