Provider Demographics
NPI:1679698138
Name:POESCHEL, SCOTT WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:WILLIAM
Last Name:POESCHEL
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 WOODDALE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2983
Mailing Address - Country:US
Mailing Address - Phone:651-756-7380
Mailing Address - Fax:
Practice Address - Street 1:1818 WOODDALE DR STE 100
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2983
Practice Address - Country:US
Practice Address - Phone:651-756-7380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4261-012111N00000X
MN3949111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor