Provider Demographics
NPI:1578634341
Name:SCIRANKA, SCOTT MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MICHAEL
Last Name:SCIRANKA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2693 VININGS CENTRAL DR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6788
Mailing Address - Country:US
Mailing Address - Phone:770-961-2474
Mailing Address - Fax:770-961-2473
Practice Address - Street 1:7147 JONESBORO RD STE J
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2954
Practice Address - Country:US
Practice Address - Phone:770-961-2474
Practice Address - Fax:770-961-2473
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA7100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor