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General NPI Number Information
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NPI Number | 1275844409
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Entity Type | Organization
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Legal Business Name | SCOTT HADLEY, LLC
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 756 COIT AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-1508
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Country | US
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Telephone | 616-826-1576
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Fax |
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Provider Business Mailing Address
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Address Line | 756 COIT AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-1508
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Country | US
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Telephone | 616-826-1576
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SCOTT D HADLEY
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Credential | DPT
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Telephone | 616-826-1576
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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 | 5501013534
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License Number State | MI
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