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General NPI Number Information
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NPI Number | 1265447924
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Entity Type | Individual
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Provider Name | SCOTT DANIEL TENNIS PT
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Gender | Male
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 1411 S MOUNTAIN RD STE D
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City | JOPPA
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State | MD
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Zip | 21085-3202
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Country | US
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Telephone | 410-676-6767
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Fax | 410-676-6770
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Provider Business Mailing Address
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Address Line | PO BOX 179
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City | FOREST HILL
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State | MD
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Zip | 21050-0179
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Country | US
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Telephone | 410-676-6767
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Fax | 410-676-6770
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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 | 19706
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License Number State | MD
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