Provider Demographics
NPI:1225134307
Name:MCGAW, SCOTT CHARLES (PT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:CHARLES
Last Name:MCGAW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:265 LOWER EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-5254
Mailing Address - Country:US
Mailing Address - Phone:435-513-1906
Mailing Address - Fax:435-645-9409
Practice Address - Street 1:3100 W. PINEBROOK ROAD
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5536
Practice Address - Country:US
Practice Address - Phone:435-513-1906
Practice Address - Fax:513-645-9409
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT121853-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist