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General NPI Number Information
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NPI Number | 1497930770
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Entity Type | Individual
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Provider Name | MARYELLEN SCHERL
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Gender | Female
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 1485 INTERNATIONAL PKWY
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City | HEATHROW
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State | FL
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Zip | 32746-5303
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Country | US
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Telephone | 800-798-6035
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Fax |
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Provider Business Mailing Address
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Address Line | 4021 HOLSTON CT
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City | SUFFOLK
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State | VA
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Zip | 23435-3293
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Country | US
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Telephone | 757-814-4309
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306602092
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License Number State | VA
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