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Individual

MR. SCOTT SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
22 TOMPKINS ST, WATERBURY, CT 06708-1458
(203) 419-0381
(203) 419-0389
Mailing address
22 TOMPKINS ST, WATERBURY, CT 06708-1458
(203) 419-0381
(203) 419-0389

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004363
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004190328
CT
Enumeration date
12/22/2006
Last updated
03/08/2013
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