Provider Demographics
NPI:1487844361
Name:GRIGGS, SCOTT C (MPT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:GRIGGS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 140C
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-9787
Mailing Address - Country:US
Mailing Address - Phone:570-265-1111
Mailing Address - Fax:570-265-7134
Practice Address - Street 1:239 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-9302
Practice Address - Country:US
Practice Address - Phone:570-587-2142
Practice Address - Fax:570-587-1978
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1990391OtherBLUE SHIELD
PA9553096OtherAETNA
822755OtherFIRST PRIORITY HEALTH
822755OtherFIRST PRIORITY HEALTH