Provider Demographics
NPI:1003860156
Name:MCBRAYER, SCOTT ANDREW (DC, CCSP, EMT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANDREW
Last Name:MCBRAYER
Suffix:
Gender:M
Credentials:DC, CCSP, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8030
Mailing Address - Country:US
Mailing Address - Phone:970-609-1160
Mailing Address - Fax:970-007-7734
Practice Address - Street 1:2615 GRAND AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8030
Practice Address - Country:US
Practice Address - Phone:970-609-1160
Practice Address - Fax:970-400-7773
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO805088Medicare ID - Type Unspecified