Provider Demographics
NPI:1053920256
Name:PRATT, SCOTT (MS ATC LAT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:PRATT
Suffix:
Gender:M
Credentials:MS ATC LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-8136
Mailing Address - Country:US
Mailing Address - Phone:158-528-0314
Mailing Address - Fax:
Practice Address - Street 1:135 WOODBURY RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-8136
Practice Address - Country:US
Practice Address - Phone:585-280-3142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program