Provider Demographics
NPI:1134151467
Name:BURNS, SCOTT (PT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:BURNS
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 1:1266 BROWNING CT
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5385
Mailing Address - Country:US
Mailing Address - Phone:303-956-0619
Mailing Address - Fax:
Practice Address - Street 1:3307 N BROAD ST
Practice Address - Street 2:JONES HALL, ROOM 618
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5101
Practice Address - Country:US
Practice Address - Phone:215-707-9121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9004225100000X
PA0199512251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist