Individual
SCOTT HARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
715 E RAYMOND RD, WATSEKA, IL 60970-9730
(815) 432-5476
Mailing address
7772 E 4500S RD, SAINT ANNE, IL 60964-4081
(815) 530-7255
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.006891
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4511
NONE
IL
Enumeration date
04/21/2022
Last updated
04/21/2022
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