Provider Demographics
NPI:1073851986
Name:SCOTT, GERALD ARTHUR (HOLISTIC HEALTH)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:ARTHUR
Last Name:SCOTT
Suffix:
Gender:M
Credentials:HOLISTIC HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 TOWNEPARK CIR.
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243
Mailing Address - Country:US
Mailing Address - Phone:502-797-6618
Mailing Address - Fax:
Practice Address - Street 1:205 TOWNEPARK CIR
Practice Address - Street 2:SUIT 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2318
Practice Address - Country:US
Practice Address - Phone:502-797-6618
Practice Address - Fax:877-273-4414
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath