Provider Demographics
NPI:1770650095
Name:MCLAY, SCOTT IAN (BS, MBA, LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:IAN
Last Name:MCLAY
Suffix:
Gender:M
Credentials:BS, MBA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 LOVELL PL
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16503-2641
Mailing Address - Country:US
Mailing Address - Phone:702-429-2744
Mailing Address - Fax:
Practice Address - Street 1:201 E 8TH ST
Practice Address - Street 2:ERIE OTTERS HOCKEY CLUB
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16503-1003
Practice Address - Country:US
Practice Address - Phone:814-455-7779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0506039OtherNVBAT- NEVADA ATHLETIC TRAINER LICENSE
080302127OtherNATABOC
MI2601000846OtherLARA - MICHIGAN ATHLETIC TRAINER LICENSE