MEDICARE: MR. SCOTT JOSEPH HARTUNG P.T.

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	225100000X	Physical Therapist	1705	NV

General Provider Information

NPI Number	:	1639120181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT JOSEPH HARTUNG P.T.

Provider Business Mailing Address
First Line	:	969 VIA COLUMBO ST
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89011-0108
Country	:	US
Telephone Number	:	702-336-3003
Fax Number	:	702-473-9452

Provider Business Practice Location Address
First Line	:	969 VIA COLUMBO ST
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89011-0108
Country	:	US
Telephone Number	:	702-336-3003
Fax Number	:	702-473-9452

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	04/29/2015

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