Provider Demographics
NPI:1346355781
Name:SCOTT, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SCOTT
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 1:2297 N HILLFIELD RD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-444-3033
Mailing Address - Fax:801-728-4915
Practice Address - Street 1:2297 N HILLFIELD RD.
Practice Address - Street 2:SUITE 101
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-444-3033
Practice Address - Fax:801-728-4915
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4957561-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU89733Medicare UPIN