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General NPI Number Information
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NPI Number | 1053542126
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Entity Type | Individual
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Provider Name | GARRETT SCOTT NAZE DPT
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Gender | Male
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 06/19/2024
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Provider Practice Location Address
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Address Line | 740 S LIMESTONE STE E-214 UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
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City | LEXINGTON
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State | KY
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Zip | 40536-0284
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Country | US
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Telephone | 859-323-5500
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Fax | 859-257-5859
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Provider Business Mailing Address
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Address Line | 740 S LIMESTONE STE E-214 UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
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City | LEXINGTON
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State | KY
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Zip | 40536-0284
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Country | US
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Telephone | 859-323-5500
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Fax | 859-257-5859
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11294024
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P14525
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License Number State | NC
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