Provider Demographics
NPI:1679566244
Name:SPRINGSTEAD, SCOTT BRIAN (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:BRIAN
Last Name:SPRINGSTEAD
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 1:921 STATE ST
Mailing Address - Street 2:
Mailing Address - City:OGDENSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:13669-3347
Mailing Address - Country:US
Mailing Address - Phone:315-394-2225
Mailing Address - Fax:315-394-0438
Practice Address - Street 1:316 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:OGDENSBURG
Practice Address - State:NY
Practice Address - Zip Code:13669-2503
Practice Address - Country:US
Practice Address - Phone:315-394-2225
Practice Address - Fax:315-394-0438
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor