Provider Demographics
NPI:1275676777
Name:EVANS, SCOTT DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DAVID
Last Name:EVANS
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 1:4650 W 38TH AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2161
Mailing Address - Country:US
Mailing Address - Phone:303-433-5433
Mailing Address - Fax:303-433-8432
Practice Address - Street 1:4650 W 38TH AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2161
Practice Address - Country:US
Practice Address - Phone:303-433-5433
Practice Address - Fax:303-433-8432
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor