Provider Demographics
NPI:1184872434
Name:HARTMAN, SCOTT ALAN (PTA)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ALAN
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3077 E 98TH ST
Mailing Address - Street 2:SUITE 265
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-2940
Mailing Address - Country:US
Mailing Address - Phone:317-569-1170
Mailing Address - Fax:
Practice Address - Street 1:3077 EAST 96TH STREET
Practice Address - Street 2:265
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280
Practice Address - Country:US
Practice Address - Phone:866-855-4450
Practice Address - Fax:317-569-1179
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06001241A208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation