Provider Demographics
NPI:1578683959
Name:HOURIGAN, SCOTT ALAN (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALAN
Last Name:HOURIGAN
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 1:211 MAIN ST
Mailing Address - Street 2:STE 2
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783
Mailing Address - Country:US
Mailing Address - Phone:605-644-9074
Mailing Address - Fax:605-722-0306
Practice Address - Street 1:211 MAIN ST
Practice Address - Street 2:STE 2
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783
Practice Address - Country:US
Practice Address - Phone:605-644-9074
Practice Address - Fax:605-722-0306
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7604583Medicaid
0100864Medicare ID - Type Unspecified
SD7604583Medicaid
U78776Medicare UPIN