Provider Demographics
NPI:1790170876
Name:DR BRIAN SCOTT LLC
Entity Type:Organization
Organization Name:DR BRIAN SCOTT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-337-5156
Mailing Address - Street 1:1658 PLEASURE HOUSE RD
Mailing Address - Street 2:#104
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-4051
Mailing Address - Country:US
Mailing Address - Phone:757-337-5156
Mailing Address - Fax:
Practice Address - Street 1:1658 PLEASURE HOUSE RD
Practice Address - Street 2:#104
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-4051
Practice Address - Country:US
Practice Address - Phone:757-337-5156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557239111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty