Provider Demographics
NPI:1306504758
Name:SCOTT THERAPY LLC
Entity type:Organization
Organization Name:SCOTT THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MELLISH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:602-980-7090
Mailing Address - Street 1:1307 N 102ND WAY
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-4553
Mailing Address - Country:US
Mailing Address - Phone:602-980-7090
Mailing Address - Fax:
Practice Address - Street 1:1307 N 102ND WAY
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-4553
Practice Address - Country:US
Practice Address - Phone:602-980-7090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty