Provider Demographics
NPI:1649943226
Name:SCOLES, BRETT N (DPT)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:N
Last Name:SCOLES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:WI
Mailing Address - Zip Code:54822-0047
Mailing Address - Country:US
Mailing Address - Phone:715-204-4787
Mailing Address - Fax:855-918-3585
Practice Address - Street 1:610 W MAIN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:CAMERON
Practice Address - State:WI
Practice Address - Zip Code:54822
Practice Address - Country:US
Practice Address - Phone:715-204-4787
Practice Address - Fax:855-918-3585
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15562225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist