Basic Information
| Provider Information | |||||||||
| NPI: | 1427490580 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GETSOIAN | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 802 RIVERS EDGE DR | ||||||||
| Address2: | |||||||||
| City: | MINOOKA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604479380 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8158285940 | ||||||||
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| Practice Location | |||||||||
| Address1: | 301 MADISON ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | JOLIET | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604356549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157257133 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2013 | ||||||||
| LastUpdateDate: | 07/18/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 070014592 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.