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NPI 1528972106

NPI 1528972106 : MADISON LEE SCOTT PTA : NELSONVILLE, OH

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General NPI Number Information
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    NPI Number           |    1528972106
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    Entity Type          |    Individual 
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    Provider Name        |    MADISON LEE SCOTT PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/30/2026
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    Last Update Date     |    09/30/2026
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Provider Practice Location Address
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    Address Line         |    99 CRIHFIELD DR 
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    City                 |    NELSONVILLE
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    State                |    OH
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    Zip                  |    45764-8011
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    Country              |    US
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    Telephone            |    937-422-6140
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    99 CRIHFIELD DR 
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    City                 |    NELSONVILLE
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    State                |    OH
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    Zip                  |    45764-8011
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    Country              |    US
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    Telephone            |    937-422-6140
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    PTA010091
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    License Number State |    OH
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