Provider Demographics
NPI:1760411011
Name:SCHEELE, C. JEANNE (PT)
Entity Type:Individual
Prefix:
First Name:C.
Middle Name:JEANNE
Last Name:SCHEELE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5275 LEE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-1619
Mailing Address - Country:US
Mailing Address - Phone:703-532-4892
Mailing Address - Fax:703-237-3105
Practice Address - Street 1:5275 LEE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-1619
Practice Address - Country:US
Practice Address - Phone:703-532-4892
Practice Address - Fax:703-237-3105
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305000944225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014124K57Medicare ID - Type Unspecified