Provider Demographics
NPI:1326485418
Name:THACH, SCOTT (MSPO, CO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:THACH
Suffix:
Gender:M
Credentials:MSPO, CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TIMBERHILL PL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1963
Mailing Address - Country:US
Mailing Address - Phone:810-853-0907
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:PROSTHETICS AND ORTHOTICS DEPT
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-4630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist