Provider Demographics
NPI:1649616145
Name:FEIN, SCOT HARRISON
Entity type:Individual
Prefix:
First Name:SCOT
Middle Name:HARRISON
Last Name:FEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 E 14TH AVE
Mailing Address - Street 2:#14A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-5402
Mailing Address - Country:US
Mailing Address - Phone:719-659-7980
Mailing Address - Fax:
Practice Address - Street 1:1323 E 14TH AVE
Practice Address - Street 2:#14A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-5402
Practice Address - Country:US
Practice Address - Phone:719-659-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-12
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0014069225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist