Provider Demographics
NPI:1073750782
Name:JO ANN SCOTT CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:JO ANN SCOTT CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JO ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-249-2720
Mailing Address - Street 1:30100 CROWN VALLEY PKWY
Mailing Address - Street 2:SUITE 16
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2041
Mailing Address - Country:US
Mailing Address - Phone:949-249-2720
Mailing Address - Fax:949-249-1846
Practice Address - Street 1:30100 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 16
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2041
Practice Address - Country:US
Practice Address - Phone:949-249-2720
Practice Address - Fax:949-249-1846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC21541Medicare PIN