Provider Demographics
NPI:1164501524
Name:SCARLETT, RONI J (PT)
Entity Type:Individual
Prefix:
First Name:RONI
Middle Name:J
Last Name:SCARLETT
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 1:3064 E COUNTY ROAD 550 S
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47220-9658
Mailing Address - Country:US
Mailing Address - Phone:812-358-5380
Mailing Address - Fax:812-358-9315
Practice Address - Street 1:3064 E COUNTY ROAD 550 S
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47220-9658
Practice Address - Country:US
Practice Address - Phone:812-358-5380
Practice Address - Fax:812-358-9315
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003222A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist