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NPI Code Detail

MEDICARE: SHANNON SCOTT

MEDICARE: SHANNON SCOTT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist19220MT

General Provider Information

NPI Number : 1578187787
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON SCOTT
Provider Business Mailing Address
First Line : 5000 BLUE MOUNTAIN RD
Second Line :
City : MISSOULA
State : MT
Zip : 59804-9213
Country : US
Telephone Number : 406-251-2323
Fax Number : 406-251-2999
Provider Business Practice Location Address
First Line : 1016 BROOKS AVE
Second Line :
City : CORVALLIS
State : MT
Zip : 59828-9340
Country : US
Telephone Number : 406-961-3841
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2020
Last Update Date : 01/07/2026

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Directions to “ SHANNON SCOTT ” Practice Location

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