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NPI Code Detail

MEDICARE: MR. SCOTT BRIAN CRILLY P.T.

MEDICARE: MR. SCOTT BRIAN CRILLY P.T.
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 Therapist5501003098MI

General Provider Information

NPI Number : 1811148703
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SCOTT BRIAN CRILLY P.T.
Provider Business Mailing Address
First Line : 2775 E LANSING DR
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-7755
Country : US
Telephone Number : 517-332-1616
Fax Number : 517-336-4797
Provider Business Practice Location Address
First Line : 2775 E LANSING DR
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-7755
Country : US
Telephone Number : 517-332-1616
Fax Number : 517-336-4797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2008
Last Update Date : 10/09/2008

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