Provider Demographics
NPI:1407200983
Name:WORKMAN, SCOTT D (PTA)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:D
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 NEWBURG ROAD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-2445
Mailing Address - Country:US
Mailing Address - Phone:502-451-6886
Mailing Address - Fax:502-458-2158
Practice Address - Street 1:3430 NEWBURG ROAD
Practice Address - Street 2:SUITE 111
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-2445
Practice Address - Country:US
Practice Address - Phone:502-451-6886
Practice Address - Fax:502-458-2158
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA01185225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist