Provider Demographics
NPI:1376814475
Name:SCHOLTEN, DANA BETH (PTA)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:BETH
Last Name:SCHOLTEN
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 1:909 E PRAIRIE ST
Mailing Address - Street 2:PO BOX 53
Mailing Address - City:BOYDEN
Mailing Address - State:IA
Mailing Address - Zip Code:51234-7744
Mailing Address - Country:US
Mailing Address - Phone:712-725-2634
Mailing Address - Fax:
Practice Address - Street 1:706 EAGLE RUN
Practice Address - Street 2:
Practice Address - City:DELL RAPIDS
Practice Address - State:SD
Practice Address - Zip Code:57022-2142
Practice Address - Country:US
Practice Address - Phone:605-428-5851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01146225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant