MEDICARE: DR. MARK ANDREW 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	6329	CO

General Provider Information

NPI Number	:	1841434073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK ANDREW SCOTT D.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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2009
Last Update Date	:	08/09/2011

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