Provider Demographics
NPI:1730503574
Name:SCHOLTEN, SHARON BROGIE (PT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:BROGIE
Last Name:SCHOLTEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:ELIZABETH
Other - Last Name:BROGIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:24 LYMAN ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1482
Mailing Address - Country:US
Mailing Address - Phone:508-329-1163
Mailing Address - Fax:508-986-7026
Practice Address - Street 1:24 LYMAN ST
Practice Address - Street 2:SUITE 140
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1482
Practice Address - Country:US
Practice Address - Phone:508-329-1163
Practice Address - Fax:508-986-7026
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist