Healthcare Provider Details

I. General information

NPI: 1245371665
Provider Name (Legal Business Name): SCHARLA KEETON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W MCCLANAHAN ST
OXFORD NC
27565-2927
US

IV. Provider business mailing address

PO BOX 1697
OXFORD NC
27565-1697
US

V. Phone/Fax

Practice location:
  • Phone: 919-693-1671
  • Fax: 919-693-9381
Mailing address:
  • Phone: 919-693-1671
  • Fax: 919-693-9381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3585
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: