MEDICARE: SCOTT ALAN ANDERSON ATC

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	174400000X	Specialist	003	OK

General Provider Information

NPI Number	:	1538131271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT ALAN ANDERSON ATC

Provider Business Mailing Address
First Line	:	180 W BROOKS ST
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73019-1018
Country	:	US
Telephone Number	:	405-325-8332
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 W BROOKS ST
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73019-1018
Country	:	US
Telephone Number	:	405-325-8332
Fax Number	:

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	07/08/2007

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Directions to “ SCOTT ALAN ANDERSON ATC” Practice Location

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