Provider Demographics
NPI:1699022343
Name:SCOTT, CARRIE ELISE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ELISE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ELISE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1570 KINGSWAY CT
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1960
Mailing Address - Country:US
Mailing Address - Phone:734-676-7400
Mailing Address - Fax:734-676-5139
Practice Address - Street 1:1570 KINGSWAY CT
Practice Address - Street 2:SUITE 2
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-1960
Practice Address - Country:US
Practice Address - Phone:734-676-7400
Practice Address - Fax:734-676-5139
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist