Provider Demographics
NPI:1477207256
Name:SCOTT, ANDREW MATTHEW (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MATTHEW
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2987 RIVERBEND DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2190
Mailing Address - Country:US
Mailing Address - Phone:818-263-1701
Mailing Address - Fax:
Practice Address - Street 1:14394 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2756
Practice Address - Country:US
Practice Address - Phone:818-263-1701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist