Provider Demographics
NPI:1194814384
Name:LOVE, SCOTT M (DPT)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:LOVE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 UPPER SNAKE SPRING RD
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-6360
Mailing Address - Country:US
Mailing Address - Phone:814-623-5749
Mailing Address - Fax:814-623-1807
Practice Address - Street 1:407 UPPER SNAKE SPRING RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-6360
Practice Address - Country:US
Practice Address - Phone:814-623-5749
Practice Address - Fax:814-623-1807
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013484L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000826942OtherHIGHMARK
PA0018150750001Medicaid
PA000826942OtherHIGHMARK