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General NPI Number Information
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NPI Number | 1366772642
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Entity Type | Individual
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Provider Name | SCOTT INGELL LMT
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Gender | Male
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Dates
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Enumeration Date | 01/08/2010
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 6251 E BRAINERD RD
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3913
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Country | US
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Telephone | 423-855-4888
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Fax | 423-305-1752
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Provider Business Mailing Address
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Address Line | P.O. BOX 21221
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City | CHATTANOOGA
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State | TN
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Zip | 37424
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Country | US
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Telephone | 423-855-4888
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 613
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License Number State | TN
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