Healthcare Provider Details

I. General information

NPI: 1487737102
Provider Name (Legal Business Name): SCOTT E HARMON PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SCOTT LN # 1828
JACKSON WY
83001-8468
US

IV. Provider business mailing address

PO BOX 1828
JACKSON WY
83001-1828
US

V. Phone/Fax

Practice location:
  • Phone: 307-734-9005
  • Fax: 307-734-4424
Mailing address:
  • Phone: 307-734-9005
  • Fax: 307-734-4424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-878
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: