Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1114164316 |
---|---|
Provider Name | Robert J Scott |
First Address | Springfield, MA 01118-1252 |
Second Address | Springfield, MA 01118-1252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2009 |
Last Update Date | 11/01/2009 |