Provider Demographics
NPI:1407822505
Name:KUGLER, SCOTT DANIEL (ATC, LMT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DANIEL
Last Name:KUGLER
Suffix:
Gender:M
Credentials:ATC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10942 PEM RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5410
Mailing Address - Country:US
Mailing Address - Phone:314-853-2324
Mailing Address - Fax:
Practice Address - Street 1:333 S KIRKWOOD RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-6161
Practice Address - Country:US
Practice Address - Phone:314-909-0517
Practice Address - Fax:314-909-0518
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070280222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer