Provider Demographics
NPI:1346427226
Name:SCOTT L. MILLISON, D.C.
Entity Type:Organization
Organization Name:SCOTT L. MILLISON, D.C.
Other - Org Name:YORK ROAD CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-628-2808
Mailing Address - Street 1:10153 YORK RD STE 105
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3398
Mailing Address - Country:US
Mailing Address - Phone:410-628-2808
Mailing Address - Fax:410-628-2818
Practice Address - Street 1:10153 YORK RD STE 105
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3398
Practice Address - Country:US
Practice Address - Phone:410-628-2808
Practice Address - Fax:410-628-2818
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCOTT L. MILLISON, D.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-23
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO1131332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0438660001Medicare NSC