Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 2808 | CO |
NPI | 1063513208 |
---|---|
Provider Name | Dr. Scott Randall Cramer |
First Address | Colorado Springs, CO 80917-5743 |
Second Address | Colorado Springs, CO 80917-5743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C26473 | (02) | CO |