Provider Demographics
NPI:1225209786
Name:RISLEY, SCOTT ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALAN
Last Name:RISLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 BOB BILLINGS PKWY
Mailing Address - Street 2:STE. B
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3855
Mailing Address - Country:US
Mailing Address - Phone:785-865-6030
Mailing Address - Fax:785-865-6031
Practice Address - Street 1:4920 BOB BILLINGS PKWY
Practice Address - Street 2:STE. B
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-3855
Practice Address - Country:US
Practice Address - Phone:785-865-6030
Practice Address - Fax:785-865-6031
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05201111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor