Provider Demographics
NPI:1851430623
Name:SCOTT, VELMA EADIE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:VELMA
Middle Name:EADIE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:VELMA
Other - Middle Name:BONITA
Other - Last Name:EADIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:83 BEAUFAIN ST
Mailing Address - Street 2:APT H
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1996
Mailing Address - Country:US
Mailing Address - Phone:843-817-7234
Mailing Address - Fax:
Practice Address - Street 1:83 BEAUFAIN ST APT H
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1996
Practice Address - Country:US
Practice Address - Phone:843-817-7234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1729225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant