Provider Demographics
NPI:1003473018
Name:SCOTT, KENDRA ANN (DPT)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:ANN
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 1:202 E EARLL DR STE 360
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2677
Mailing Address - Country:US
Mailing Address - Phone:480-788-5621
Mailing Address - Fax:480-779-1277
Practice Address - Street 1:202 E EARLL DR STE 360
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2677
Practice Address - Country:US
Practice Address - Phone:480-788-5621
Practice Address - Fax:480-779-1277
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist