Provider Demographics
NPI:1659587509
Name:SCHOLL, KENNETH ROY (MSPT)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:ROY
Last Name:SCHOLL
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 VILLAGE BLVD
Mailing Address - Street 2:#302
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-7483
Mailing Address - Country:US
Mailing Address - Phone:561-689-4846
Mailing Address - Fax:
Practice Address - Street 1:1920 PALM BEACH LAKES BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3512
Practice Address - Country:US
Practice Address - Phone:561-688-7911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL20166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist