Provider Demographics
NPI:1811613722
Name:SCOTT, KARA MICHELLE (DC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MICHELLE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-3919
Mailing Address - Country:US
Mailing Address - Phone:817-560-1625
Mailing Address - Fax:817-560-1627
Practice Address - Street 1:2603 CHERRY LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-3919
Practice Address - Country:US
Practice Address - Phone:817-560-1625
Practice Address - Fax:817-560-1627
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15350111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor