Provider Demographics
NPI:1215016092
Name:INGLISH, SCOTT M (PT MOMT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:M
Last Name:INGLISH
Suffix:
Gender:M
Credentials:PT MOMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 E SOUTHERN AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206
Mailing Address - Country:US
Mailing Address - Phone:480-981-1201
Mailing Address - Fax:480-981-8440
Practice Address - Street 1:4545 E SOUTHERN AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-981-1201
Practice Address - Fax:480-981-8440
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ77262Medicare ID - Type Unspecified