Provider Demographics
NPI:1407820541
Name:CABAZOLO, SCOTT D (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:D
Last Name:CABAZOLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:D
Other - Last Name:CABAZOLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:112 E 6TH ST
Mailing Address - Street 2:# A
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-3444
Mailing Address - Country:US
Mailing Address - Phone:540-622-6400
Mailing Address - Fax:540-622-6401
Practice Address - Street 1:112 E 6TH ST
Practice Address - Street 2:# A
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3444
Practice Address - Country:US
Practice Address - Phone:540-622-6400
Practice Address - Fax:540-622-6401
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU64343Medicare UPIN
VA350000716Medicare PIN