Healthcare Provider Details

I. General information

NPI: 1053542126
Provider Name (Legal Business Name): GARRETT SCOTT NAZE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11110 MEDICAL CAMPUS RD STE 201
HAGERSTOWN MD
21742-6797
US

IV. Provider business mailing address

217 MOUNTAIN TER
MYERSVILLE MD
21773-8431
US

V. Phone/Fax

Practice location:
  • Phone: 301-714-4025
  • Fax:
Mailing address:
  • Phone: 262-402-3093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP14525
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number30468
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11294024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: