MEDICARE: VINCENT E SCOTT MPT

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	225100000X	Physical Therapist	3992	NV

General Provider Information

NPI Number	:	1790056745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT E SCOTT MPT

Provider Business Mailing Address
First Line	:	4829 SPANISH RIVER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-5122
Country	:	US
Telephone Number	:	856-495-2866
Fax Number	:

Provider Business Practice Location Address
First Line	:	4829 SPANISH RIVER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-5122
Country	:	US
Telephone Number	:	856-495-2866
Fax Number	:

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

Provider Enumeration Date	:	01/23/2012
Last Update Date	:	02/14/2022

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Directions to “ VINCENT E SCOTT MPT” Practice Location

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