Provider Demographics
NPI:1528024361
Name:SWOPE, SCOTT BRADLEY (ATC, LAT, EMT-P)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:BRADLEY
Last Name:SWOPE
Suffix:
Gender:M
Credentials:ATC, LAT, EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 TEN OAKS DR E
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4061
Mailing Address - Country:US
Mailing Address - Phone:615-822-7133
Mailing Address - Fax:615-230-3629
Practice Address - Street 1:1040 BISON TRL
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-8460
Practice Address - Country:US
Practice Address - Phone:615-451-6551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMT0000019804146L00000X
TNAT00000001022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic