Provider Demographics
NPI:1104140482
Name:BOSCHETTO, SCOTT ANDREW (PT ATC)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ANDREW
Last Name:BOSCHETTO
Suffix:
Gender:M
Credentials:PT ATC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:725 ALSTONEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-5074
Mailing Address - Country:US
Mailing Address - Phone:678-409-3243
Mailing Address - Fax:678-624-0708
Practice Address - Street 1:725 ALSTONEFIELD DR
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-5074
Practice Address - Country:US
Practice Address - Phone:678-409-3243
Practice Address - Fax:678-624-0708
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0019462251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic