Provider Demographics
NPI:1528210192
Name:ULRICK, SCOTT ALAN (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALAN
Last Name:ULRICK
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 1:5120 W. MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035
Mailing Address - Country:US
Mailing Address - Phone:602-269-8711
Mailing Address - Fax:602-269-5698
Practice Address - Street 1:5120 W. MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035
Practice Address - Country:US
Practice Address - Phone:602-269-8711
Practice Address - Fax:602-269-5698
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor