| Doctor Name: | THEODORE SCOVILLE |
| NPI Number: | 1609978212 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 24928 |
| Business Practice Address: | 3323 Mission Dr Santa Cruz, CA - 950651827 |
| Business Phone Number: | 8312243143 |
| Business Fax Number: | 8314650109 |
| Mailing Address: | 4301 Grace St, 3 CAPITOLA |
| State: | CA |
| Postal Code: | 950103575 |
| Phone Number: | 8312243143 |
| Fax Number: | |
| NPI Enumeration Date: | 09/03/2006 |
| NPI Last Update Date: | 01/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 24928 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |