Provider Demographics
NPI:1053490953
Name:SCOTT, EVE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:MARIE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4579 S COBB DRIVE, SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6389
Mailing Address - Country:US
Mailing Address - Phone:770-436-3665
Mailing Address - Fax:700-436-3886
Practice Address - Street 1:4579 S COBB DRIVE, SE
Practice Address - Street 2:SUITE 100
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6389
Practice Address - Country:US
Practice Address - Phone:770-436-3665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007852225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist