MEDICARE: DR. ROYLENE DEBRA SCOTT D.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	111N00000X	Chiropractor	DC26036	CA

General Provider Information

NPI Number	:	1295004026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROYLENE DEBRA SCOTT D.C.

Provider Business Mailing Address
First Line	:	12523 LIMONITE AVE # 440-403
Second Line	:
City	:	MIRA LOMA
State	:	CA
Zip	:	91752-3665
Country	:	US
Telephone Number	:	951-733-2185
Fax Number	:

Provider Business Practice Location Address
First Line	:	12523 LIMONITE AVE # 440-403
Second Line	:
City	:	MIRA LOMA
State	:	CA
Zip	:	91752-3665
Country	:	US
Telephone Number	:	951-733-2185
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2011
Last Update Date	:	12/23/2011

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