Provider Demographics
NPI:1912040981
Name:SCOTT-ANDERSON, VIOLA L
Entity Type:Individual
Prefix:MRS
First Name:VIOLA
Middle Name:L
Last Name:SCOTT-ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 BITTEROOT DR
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:MT
Mailing Address - Zip Code:59270-5633
Mailing Address - Country:US
Mailing Address - Phone:406-428-4351
Mailing Address - Fax:
Practice Address - Street 1:104 14TH AVE NW
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:MT
Practice Address - Zip Code:59270-3525
Practice Address - Country:US
Practice Address - Phone:406-488-2358
Practice Address - Fax:406-488-2260
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0349323Medicaid