Provider Demographics
NPI:1649265174
Name:WEINEL, SCOTT T (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:T
Last Name:WEINEL
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 1:599 FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:APOLLO
Mailing Address - State:PA
Mailing Address - Zip Code:15613-1142
Mailing Address - Country:US
Mailing Address - Phone:724-478-3747
Mailing Address - Fax:
Practice Address - Street 1:599 FIRST STREET
Practice Address - Street 2:
Practice Address - City:APOLLO
Practice Address - State:PA
Practice Address - Zip Code:15613-1142
Practice Address - Country:US
Practice Address - Phone:724-478-3747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005546L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01449877Medicaid
PA759448OtherBCBS
PA200148OtherUPMC HEALTH PLAN
PAJ12CWJN12502Medicare PIN
PA01449877Medicaid