MEDICARE: SCOTT CHIROPRACTIC FORT COLLINS P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	6329	CO

General Provider Information

NPI Number	:	1285922948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT CHIROPRACTIC FORT COLLINS P.C.

Provider Business Mailing Address
First Line	:	5125 S COLLEGE AVE
Second Line	:	SUITE A
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3959
Country	:	US
Telephone Number	:	970-482-1175
Fax Number	:	970-372-6459

Provider Business Practice Location Address
First Line	:	5125 S COLLEGE AVE
Second Line	:	SUITE A
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3959
Country	:	US
Telephone Number	:	970-482-1175
Fax Number	:	970-372-6459

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK ANDREW SCOTT
Credential	:	D.C.
Telephone Number	:	970-482-1175

Provider Enumeration Date	:	07/15/2011
Last Update Date	:	07/15/2011

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