Provider Demographics
NPI:1053581694
Name:SCOTT, MOLLY M (DC, FASA)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DC, FASA
Other - Prefix:DR
Other - First Name:MOLLY
Other - Middle Name:M
Other - Last Name:MEYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, FASA
Mailing Address - Street 1:15211 S BLACKBOB RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3316
Mailing Address - Country:US
Mailing Address - Phone:913-393-1303
Mailing Address - Fax:913-393-1306
Practice Address - Street 1:15211 S BLACKBOB RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3316
Practice Address - Country:US
Practice Address - Phone:913-393-1303
Practice Address - Fax:913-393-1306
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA1145001Medicare UPIN