Provider Demographics
NPI:1245269877
Name:KLINE, SCOTT D (PT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:KLINE
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 1:441 SILVERCREEK RD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9023
Mailing Address - Country:US
Mailing Address - Phone:330-696-3539
Mailing Address - Fax:
Practice Address - Street 1:717 CANTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-2606
Practice Address - Country:US
Practice Address - Phone:330-733-0504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016955225100000X
OHPT.011978225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist