Provider Demographics
NPI:1801096649
Name:SCOTT, JARED J (DC)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:J
Last Name:SCOTT
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 1:2556 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4508
Mailing Address - Country:US
Mailing Address - Phone:814-835-9020
Mailing Address - Fax:814-836-9111
Practice Address - Street 1:2556 W 12TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4508
Practice Address - Country:US
Practice Address - Phone:814-835-9020
Practice Address - Fax:814-836-9111
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor