Provider Demographics
NPI:1073768362
Name:SCOTT-ESHMAN, JODIE L (DC)
Entity Type:Individual
Prefix:MS
First Name:JODIE
Middle Name:L
Last Name:SCOTT-ESHMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:L
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:11599 PARKWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-9204
Mailing Address - Country:US
Mailing Address - Phone:412-584-4805
Mailing Address - Fax:
Practice Address - Street 1:11599 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-2061
Practice Address - Country:US
Practice Address - Phone:724-382-4982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAJ009841111N00000X
PADC010026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor