Individual
SCOTT GLEN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.P.T.
Contact information
Practice address
103 S COMMERCIAL AVE, EMMETT, ID 83617-2921
(208) 477-8028
Mailing address
PO BOX 1056, EMMETT, ID 83617-1056
(208) 477-8028
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1924
ID
Other
Enumeration date
11/12/2009
Last updated
06/20/2013
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