Provider Demographics
NPI:1265576003
Name:SALITA, SCOTT D (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:D
Last Name:SALITA
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:PO BOX 402
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-0402
Mailing Address - Country:US
Mailing Address - Phone:612-991-3139
Mailing Address - Fax:
Practice Address - Street 1:4833 MINNETONKA BLVD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2214
Practice Address - Country:US
Practice Address - Phone:612-991-3139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4370111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN119H8CHOtherBCBS MN ID#
MN331133851OtherCHIROCARE ID#
MN331133851OtherHSM ID #
MN1065328OtherAMERICAN SPECIALTY HEALTH
MN787250000Medicaid