Provider Demographics
NPI:1215708664
Name:SCOTT, KATRINA GRACE (DPT)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:GRACE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5503 SANRIA CT
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-9466
Mailing Address - Country:US
Mailing Address - Phone:724-787-6435
Mailing Address - Fax:
Practice Address - Street 1:1665 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-9217
Practice Address - Country:US
Practice Address - Phone:864-210-9673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2025-09-22
Deactivation Date:2025-09-01
Deactivation Code:
Reactivation Date:2025-09-18
Provider Licenses
StateLicense IDTaxonomies
PATPT0237872251X0800X
SCPT.13052PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic