MEDICARE: SCOTT J. MULLENMEISTER 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	111NN0400X	Neurology Chiropractor	1040	SD

General Provider Information

NPI Number	:	1821028531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT J. MULLENMEISTER D.C.

Provider Business Mailing Address
First Line	:	1415 WEST HAVENS STREET SUITE 3
Second Line	:	CHIROPRACTIC CENTER FOR HEALTH LIVING
City	:	MITCHELL
State	:	SD
Zip	:	57301-4116
Country	:	US
Telephone Number	:	605-996-1160
Fax Number	:	605-996-6433

Provider Business Practice Location Address
First Line	:	1415 WEST HAVENS STREET SUITE 3
Second Line	:	CHIROPRACTIC CENTER FOR HEALTH LIVING
City	:	MITCHELL
State	:	SD
Zip	:	57301-4116
Country	:	US
Telephone Number	:	605-996-1160
Fax Number	:	605-996-6433

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	12/12/2011

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