Reggie Scott Scott Jr.

Individual provider Active NPI Rehabilitation Practitioner · Earth City, MO

NPI 1356765374 · NPPES record last updated Feb 11, 2014

Key facts

NPI
1356765374
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Practitioner 225400000X
License
060202019 (MO)
Practice address
1 Rams Way
Earth City, MO 63045-1523
Phone
(314) 982-7267
NPI assigned
Feb 11, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
060202019MOMDRehabilitation Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 060202019 MO Yes

Addresses

Primary practice location

1 Rams Way
Earth City, MO 63045-1523

Mailing address

1 Rams Way
Earth City, MO 63045-1523

Other providers in Earth City, MO

All providers in Earth City, MO · Rehabilitation Practitioner in Missouri

Sources for this page

Verify at the official NPI Registry.