Organization
ASPEN PHYSICAL THERAPY LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI SCOTT MPT (OWNER)
(208) 233-1064
Entity
Organization
Contact information
Practice address
1800 GARRETT WAY, STE 19A, POCATELLO, ID 83201-5132
(208) 233-1064
(208) 233-0219
Mailing address
1800 GARRETT WAY, STE 19A, POCATELLO, ID 83201-5132
(208) 233-1064
(208) 233-0219
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT1078
ID
225100000X
Physical Therapist
Primary
PT1555
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000-10144181
BSID (BRANDI SCOTT)
ID
01
—
5479460
CCN (BRANDI SCOTT)
ID
01
—
7042522
AETNA
ID
01
—
85120066610450
REGENCY (BRANDI SCOTT)
ID
01
—
TA393
BCID (ASPEN PT)
ID
01
—
TA401
BCID (BRANDI SCOTT)
ID
01
—
TD471
BCID (BART MCDONALD)
ID
Enumeration date
11/28/2006
Last updated
08/22/2020
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