Provider Demographics
NPI:1548325061
Name:KRIBS, SCOTT A (DC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:KRIBS
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 1:3496 E LAKE LANSING RD STE 120
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6222
Mailing Address - Country:US
Mailing Address - Phone:517-485-1967
Mailing Address - Fax:517-485-6919
Practice Address - Street 1:3496 E LAKE LANSING RD STE 120
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6222
Practice Address - Country:US
Practice Address - Phone:517-485-1967
Practice Address - Fax:517-485-6919
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007847111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95OC313880OtherBCBSM INDIVIDUAL PIN #
MIOP23480Medicare ID - Type Unspecified
MIU74782Medicare UPIN