Healthcare Provider Details

I. General information

NPI: 1487179578
Provider Name (Legal Business Name): HANNAH E SCOTT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH JOSEPHSON PT, DPT, C/NDT

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 19TH AVE S
GRAND FORKS ND
58201-5957
US

IV. Provider business mailing address

2625 N 19TH ST
BISMARCK ND
58503-0574
US

V. Phone/Fax

Practice location:
  • Phone: 701-222-3175
  • Fax: 701-222-3186
Mailing address:
  • Phone: 701-222-3175
  • Fax: 701-222-3186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2612
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number17159
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: