Provider Demographics
NPI:1649537010
Name:MCGINN, SCOTT B (ATC, LAT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:B
Last Name:MCGINN
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N FOXRIDGE DR
Mailing Address - Street 2:APT. 203
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-7829
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5100 ROCKHILL RD
Practice Address - Street 2:SRC 201
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-2446
Practice Address - Country:US
Practice Address - Phone:816-235-1735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120382922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer