Provider Demographics
NPI:1346390275
Name:MINER, ROBERT SCOTT (D C)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SCOTT
Last Name:MINER
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 S MILL AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2845
Mailing Address - Country:US
Mailing Address - Phone:480-894-2626
Mailing Address - Fax:
Practice Address - Street 1:414 S MILL AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2845
Practice Address - Country:US
Practice Address - Phone:480-894-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7315111N00000X
AZ4065111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation