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Individual
MR. SCOTT BULGER
Active
Individual
MR. SCOTT BULGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1262117
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
437974YTNB
MEDICARE PTAN
TX
Enumeration date
08/18/2015
Last updated
12/10/2015
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