MEDICARE: DR. SCOTT A UNRUH ED.D., ATC

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
1	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	202	NE

General Provider Information

NPI Number	:	1639815418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT A UNRUH ED.D., ATC

Provider Business Mailing Address
First Line	:	UNIVERSITY OF NEBRASKA AT KEARNEY COLLEGE OF EDUCATION
Second Line	:
City	:	KEARNEY
State	:	NE
Zip	:	68849-0001
Country	:	US
Telephone Number	:	308-865-8627
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIVERSITY OF NEBRASKA AT KEARNEY COLLEGE OF EDUCATION
Second Line	:
City	:	KEARNEY
State	:	NE
Zip	:	68849-0001
Country	:	US
Telephone Number	:	308-865-8627
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2022
Last Update Date	:	05/05/2022

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