Provider Demographics
NPI:1639120181
Name:HARTUNG, SCOTT JOSEPH (PT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:JOSEPH
Last Name:HARTUNG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 VIA COLUMBO ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-0108
Mailing Address - Country:US
Mailing Address - Phone:702-336-3003
Mailing Address - Fax:702-473-9452
Practice Address - Street 1:969 VIA COLUMBO ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-0108
Practice Address - Country:US
Practice Address - Phone:702-336-3003
Practice Address - Fax:702-473-9452
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1705225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist