Provider Demographics
NPI:1679867329
Name:FOLLIS, PERRY SCOTT (DPT)
Entity Type:Individual
Prefix:MR
First Name:PERRY
Middle Name:SCOTT
Last Name:FOLLIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 W SHEPARD LN
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-9622
Mailing Address - Country:US
Mailing Address - Phone:307-679-5409
Mailing Address - Fax:
Practice Address - Street 1:86 W SHEPARD LN
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-9622
Practice Address - Country:US
Practice Address - Phone:307-679-5409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-29
Last Update Date:2011-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7921201-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist