Provider Demographics
NPI:1235332289
Name:SCHOLLER, JAMES THOMAS (ATC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:SCHOLLER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 BEALE ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-3715
Mailing Address - Country:US
Mailing Address - Phone:901-205-1145
Mailing Address - Fax:901-205-1121
Practice Address - Street 1:191 BEALE ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3715
Practice Address - Country:US
Practice Address - Phone:901-205-1145
Practice Address - Fax:901-205-1121
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 10192255A2300X
TNAT00000012662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer