Provider Demographics
NPI:1053374645
Name:BOYNTON, SCOTT NOLAN (LICAC, BAC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:NOLAN
Last Name:BOYNTON
Suffix:
Gender:M
Credentials:LICAC, BAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7593 BANTRY CT
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-9742
Mailing Address - Country:US
Mailing Address - Phone:303-779-1109
Mailing Address - Fax:
Practice Address - Street 1:1221 S CLARKSON ST
Practice Address - Street 2:STE 218
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-1625
Practice Address - Country:US
Practice Address - Phone:303-779-1109
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO169171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist