Provider Demographics
NPI:1104398221
Name:SCOTT, KAREN MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16505 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21795-1321
Mailing Address - Country:US
Mailing Address - Phone:301-582-1750
Mailing Address - Fax:
Practice Address - Street 1:16505 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:MD
Practice Address - Zip Code:21795-1321
Practice Address - Country:US
Practice Address - Phone:301-582-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1497208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation