Healthcare Provider Details

I. General information

NPI: 1427490580
Provider Name (Legal Business Name): SCOTT L GETSOIAN P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MADISON ST SUITE 300
JOLIET IL
60435-6549
US

IV. Provider business mailing address

802 RIVERS EDGE DR
MINOOKA IL
60447-9380
US

V. Phone/Fax

Practice location:
  • Phone: 815-725-7133
  • Fax:
Mailing address:
  • Phone: 815-828-5940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070014592
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: