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Individual

MR. KEITH DAVID SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
10525 WEST DR, FAIRFAX, VA 22030-4230
(703) 934-9411
(703) 934-9497
Mailing address
7727 LEEDS MANOR RD, MARSHALL, VA 20115-2657
(703) 934-9411
(703) 934-9497

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2305002566
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G02052
MEDICARE GROUP PIN
DC
Enumeration date
12/15/2006
Last updated
10/05/2007
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