Provider Demographics
NPI:1770675894
Name:UHLENHAKE, SCOTT J (PT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:J
Last Name:UHLENHAKE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PERIDOT DR
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:OH
Mailing Address - Zip Code:45302-8631
Mailing Address - Country:US
Mailing Address - Phone:419-447-7203
Mailing Address - Fax:419-447-5577
Practice Address - Street 1:326 N MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865-9500
Practice Address - Country:US
Practice Address - Phone:419-628-6920
Practice Address - Fax:419-628-8028
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist