MEDICARE: MR. SCOTT MARCHINO MPT

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

General Provider Information

NPI Number	:	1689347627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT MARCHINO MPT

Provider Business Mailing Address
First Line	:	3921 JUSTICE RD
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63034-3343
Country	:	US
Telephone Number	:	314-313-5684
Fax Number	:

Provider Business Practice Location Address
First Line	:	13700 OLD HALLS FERRY RD
Second Line	:
City	:	BLACK JACK
State	:	MO
Zip	:	63033-4109
Country	:	US
Telephone Number	:	314-355-0760
Fax Number	:

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

Provider Enumeration Date	:	07/27/2021
Last Update Date	:	07/27/2021

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Directions to “ MR. SCOTT MARCHINO MPT” Practice Location

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