MEDICARE: DR. JANE R SCOTT D.C., D.A.C.N.B.

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	CHIR02770	GA

General Provider Information

NPI Number	:	1609818517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE R SCOTT D.C., D.A.C.N.B.

Provider Business Mailing Address
First Line	:	2200 FOUNTAIN DR
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-2919
Country	:	US
Telephone Number	:	770-972-9160
Fax Number	:	770-978-1699

Provider Business Practice Location Address
First Line	:	2200 FOUNTAIN DR
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-2919
Country	:	US
Telephone Number	:	770-972-9160
Fax Number	:	770-978-1699

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	07/08/2007

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