Provider Demographics
NPI:1922555457
Name:MIDDLETON, SCOTT (DPT)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 NJ ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055
Mailing Address - Country:US
Mailing Address - Phone:609-953-7227
Mailing Address - Fax:
Practice Address - Street 1:128 ROUTE 70
Practice Address - Street 2:#2C
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2371
Practice Address - Country:US
Practice Address - Phone:609-953-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01674200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist