Provider Demographics
NPI:1285046615
Name:MAGNEN, SCOTT
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:MAGNEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26423 260TH AVE
Mailing Address - Street 2:
Mailing Address - City:SLEEPY EYE
Mailing Address - State:MN
Mailing Address - Zip Code:56085-4196
Mailing Address - Country:US
Mailing Address - Phone:507-227-4546
Mailing Address - Fax:
Practice Address - Street 1:1324 5TH NORTH ST
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-1514
Practice Address - Country:US
Practice Address - Phone:507-217-5649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer