Provider Demographics
NPI:1841578176
Name:CARON, SCOTT DOUGLASS (CMT, LMT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DOUGLASS
Last Name:CARON
Suffix:
Gender:M
Credentials:CMT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1889 PAGE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1909
Mailing Address - Country:US
Mailing Address - Phone:707-332-4097
Mailing Address - Fax:
Practice Address - Street 1:1889 PAGE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1909
Practice Address - Country:US
Practice Address - Phone:707-332-4097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist