Provider Demographics
NPI:1730145830
Name:SCOTT, STEPHEN M (PT, DPT, LLT, JD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PT, DPT, LLT, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1892 GRAVES MILL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502
Mailing Address - Country:US
Mailing Address - Phone:434-385-1680
Mailing Address - Fax:434-385-1682
Practice Address - Street 1:1892 GRAVES MILL RD
Practice Address - Street 2:SUITE C
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4200
Practice Address - Country:US
Practice Address - Phone:434-385-1680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist