Individual
SCOTT DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 PARSONAGE RD STE 508, EDISON, NJ 08837-2475
(732) 906-1144
Mailing address
1440 FOX PL, S PLAINFIELD, NJ 07080-1534
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QB00161000
LICENSE#
NJ
Enumeration date
04/10/2007
Last updated
07/08/2007
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