Doctor Name: | SCOTT GORHAM |
NPI Number: | 1831575299 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 9763 |
Business Practice Address: | 11671 Fountains Dr Suite 200 Maple Grove, MN - 553694711 |
Business Phone Number: | 7635850619 |
Business Fax Number: | |
Mailing Address: | 9775 Egret Blvd, COON RAPIDS |
State: | MN |
Postal Code: | 55433 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/07/2015 |
NPI Last Update Date: | 08/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 9763 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
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 |