Provider Demographics
NPI:1528221363
Name:CRILL, JOHN SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SCOTT
Last Name:CRILL
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 1:2945 BELL RD
Mailing Address - Street 2:STE 262
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2540
Mailing Address - Country:US
Mailing Address - Phone:916-789-0222
Mailing Address - Fax:
Practice Address - Street 1:457 GRASS VALLEY HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3725
Practice Address - Country:US
Practice Address - Phone:530-878-5150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19422111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation