Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5386 | CO |
NPI | 1003860156 |
---|---|
Provider Name | Scott Andrew Mcbrayer |
First Address | Grand Junction, CO 81501-5368 |
Second Address | Grand Junction, CO 81501-5368 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 04/03/2013 |