Provider Demographics
NPI:1073711446
Name:SCOTT FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:SCOTT FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-663-2225
Mailing Address - Street 1:1491 DENVER AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-5228
Mailing Address - Country:US
Mailing Address - Phone:970-663-2225
Mailing Address - Fax:970-593-6748
Practice Address - Street 1:1491 DENVER AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5228
Practice Address - Country:US
Practice Address - Phone:970-663-2225
Practice Address - Fax:970-593-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4075111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COJ0223Medicare PIN
COJ0213Medicare PIN