Provider Demographics
NPI:1457326068
Name:WARD, SCOT A (ATC)
Entity Type:Individual
Prefix:MR
First Name:SCOT
Middle Name:A
Last Name:WARD
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BOSTON PL
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-4333
Mailing Address - Country:US
Mailing Address - Phone:603-352-2918
Mailing Address - Fax:
Practice Address - Street 1:229 MAIN STREET
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03435-0001
Practice Address - Country:US
Practice Address - Phone:603-358-2827
Practice Address - Fax:603-358-2075
Is Sole Proprietor?:No
Enumeration Date:2006-02-18
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer