Provider Demographics
NPI:1720209620
Name:RAY, JAMES SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SCOTT
Last Name:RAY
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 1:100 W.SPRUCE ST.
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027
Mailing Address - Country:US
Mailing Address - Phone:720-231-1248
Mailing Address - Fax:
Practice Address - Street 1:75 MANHATTEN DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80027
Practice Address - Country:US
Practice Address - Phone:720-231-1248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU37785Medicare UPIN
C49243Medicare ID - Type Unspecified