Healthcare Provider Details

I. General information

NPI: 1790746618
Provider Name (Legal Business Name): HAYDEN SCOTT MCDEVITT DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHLANDS DRIVE SUITE 100
LITITZ PA
17543
US

IV. Provider business mailing address

100 HIGHLANDS DRIVE SUITE 100
LITITZ PA
17543
US

V. Phone/Fax

Practice location:
  • Phone: 717-625-2228
  • Fax: 717-625-0959
Mailing address:
  • Phone: 717-625-2228
  • Fax: 717-625-0959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017556
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: