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Individual

SCOTT DEREK MATHYS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T

Contact information

Practice address
2011 HIGHWAY K, O FALLON, MO 63366-3965
(636) 379-5934
(636) 980-1059
Mailing address
2011 HIGHWAY K, O FALLON, MO 63366-3965
(636) 379-5934
(636) 980-1059

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
112431
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
160876
BLUECROSS BLUESHIELD
MO
01
2576722
UNITED HEALTHCARE
MO
01
375245
HEALTHLINK
MO
Enumeration date
09/21/2006
Last updated
07/08/2007
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