Provider Demographics
NPI:1700188836
Name:SCOVILLE OSTEOPATHIC HEALTHCARE, P.C.
Entity Type:Organization
Organization Name:SCOVILLE OSTEOPATHIC HEALTHCARE, P.C.
Other - Org Name:KATHERINE JANE SCOVILLE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:SCOVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-304-3330
Mailing Address - Street 1:10325 LLOYD RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1950
Mailing Address - Country:US
Mailing Address - Phone:301-304-3330
Mailing Address - Fax:301-304-3331
Practice Address - Street 1:10325 LLOYD RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-1950
Practice Address - Country:US
Practice Address - Phone:914-358-9559
Practice Address - Fax:914-358-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty