Provider Demographics
NPI:1023525540
Name:MCGRAW, SCOTT TIMOTHY (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:TIMOTHY
Last Name:MCGRAW
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 1:7373 147TH ST W STE 150
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7532
Mailing Address - Country:US
Mailing Address - Phone:612-481-0629
Mailing Address - Fax:
Practice Address - Street 1:7373 147TH ST W STE 150
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7532
Practice Address - Country:US
Practice Address - Phone:952-432-1522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6454111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor