Provider Demographics
NPI:1629182787
Name:REINER, SCOTT ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANDREW
Last Name:REINER
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 1:1810 STROLL CIR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-6820
Mailing Address - Country:US
Mailing Address - Phone:919-557-3841
Mailing Address - Fax:
Practice Address - Street 1:1660 S HORNER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5634
Practice Address - Country:US
Practice Address - Phone:919-777-9999
Practice Address - Fax:919-777-9998
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U71989Medicare UPIN
2452423Medicare ID - Type Unspecified