MEDICARE: MR. J SCOTT DOOLITTLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	40QB00149100	NJ

General Provider Information

NPI Number	:	1376512749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. J SCOTT DOOLITTLE

Provider Business Mailing Address
First Line	:	1881 N OLDEN AVE
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08638
Country	:	US
Telephone Number	:	609-530-0011
Fax Number	:	609-530-0666

Provider Business Practice Location Address
First Line	:	1881 N OLDEN AVE
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08638
Country	:	US
Telephone Number	:	609-530-0011
Fax Number	:	609-530-0666

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. J SCOTT DOOLITTLE ” Practice Location

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