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General NPI Number Information
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NPI Number | 1598213233
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Entity Type | Individual
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Provider Name | BRANDON SCOTT
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Gender | Male
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Dates
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Enumeration Date | 09/12/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 2589 E TOWNSHIP ROAD 86
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City | TIFFIN
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State | OH
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Zip | 44883-9738
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Country | US
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Telephone | 419-307-4309
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Fax |
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Provider Business Mailing Address
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Address Line | 2589 E TOWNSHIP ROAD 86
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City | TIFFIN
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State | OH
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Zip | 44883-9738
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Country | US
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Telephone | 419-307-4309
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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 | 10690
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License Number State | OH
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