Provider Demographics
NPI:1023114725
Name:SPINNER, SCOTT E (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:E
Last Name:SPINNER
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 1:790 AYRAULT RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-8901
Mailing Address - Country:US
Mailing Address - Phone:585-425-0190
Mailing Address - Fax:585-425-0191
Practice Address - Street 1:790 AYRAULT RD
Practice Address - Street 2:SUITE A
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-8901
Practice Address - Country:US
Practice Address - Phone:585-425-0190
Practice Address - Fax:585-425-0191
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009446-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
009446OtherPREFERRED CARE
P010009446OtherEXCELLUS BLUE CROSS/SHIEL
7199261OtherAETNA
NYU74993Medicare UPIN
P010009446OtherEXCELLUS BLUE CROSS/SHIEL