Provider Demographics
NPI:1689347627
Name:MARCHINO, SCOTT (MPT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:MARCHINO
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 1:3921 JUSTICE RD
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-3343
Mailing Address - Country:US
Mailing Address - Phone:314-313-5684
Mailing Address - Fax:
Practice Address - Street 1:13700 OLD HALLS FERRY RD
Practice Address - Street 2:
Practice Address - City:BLACK JACK
Practice Address - State:MO
Practice Address - Zip Code:63033-4109
Practice Address - Country:US
Practice Address - Phone:314-355-0760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist