Provider Demographics
NPI:1639375033
Name:SCOTT A SOLE PC
Entity Type:Organization
Organization Name:SCOTT A SOLE PC
Other - Org Name:PLATTE VALLEY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-234-5978
Mailing Address - Street 1:3800 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8170
Mailing Address - Country:US
Mailing Address - Phone:308-234-5978
Mailing Address - Fax:
Practice Address - Street 1:3800 AVENUE A
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8170
Practice Address - Country:US
Practice Address - Phone:308-234-5978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36665OtherBLUE CROSS BLUE SHIELD
NE276536Medicaid
NET60590Medicare UPIN
NE276536Medicaid