Provider Demographics
NPI:1952638801
Name:SCOTT A. DAHL D.C. PC
Entity Type:Organization
Organization Name:SCOTT A. DAHL D.C. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:DAHL
Authorized Official - Suffix:I
Authorized Official - Credentials:DC
Authorized Official - Phone:970-669-7620
Mailing Address - Street 1:2885 N GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3247
Mailing Address - Country:US
Mailing Address - Phone:970-669-7670
Mailing Address - Fax:
Practice Address - Street 1:2885 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3247
Practice Address - Country:US
Practice Address - Phone:970-669-7670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty