Provider Demographics
NPI:1023344595
Name:HEALTH CENTERED OF SCOTTSBURG, INC
Entity type:Organization
Organization Name:HEALTH CENTERED OF SCOTTSBURG, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-752-6202
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-0256
Mailing Address - Country:US
Mailing Address - Phone:812-752-6202
Mailing Address - Fax:812-752-9533
Practice Address - Street 1:40 E CHERRY ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-1814
Practice Address - Country:US
Practice Address - Phone:812-752-6202
Practice Address - Fax:812-752-9533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056407A207Q00000X
IN05005009A225100000X
IN08001735A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty