Provider Demographics
NPI:1487649034
Name:STONER, SCOTT ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALLEN
Last Name:STONER
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 1:163 TIMBER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-7445
Mailing Address - Country:US
Mailing Address - Phone:717-469-1902
Mailing Address - Fax:
Practice Address - Street 1:106 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-2205
Practice Address - Country:US
Practice Address - Phone:717-566-6000
Practice Address - Fax:717-566-6698
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003869L111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA544042PQAMedicare ID - Type Unspecified
PAU08271Medicare UPIN