Provider Demographics
NPI:1174251649
Name:SCEARCE, MICHELE NEWTON (LPTA)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:NEWTON
Last Name:SCEARCE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:NEWTON
Other - Last Name:OAKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1323 WILKERSON ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-2633
Mailing Address - Country:US
Mailing Address - Phone:434-470-9171
Mailing Address - Fax:
Practice Address - Street 1:1323 WILKERSON ST
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-2633
Practice Address - Country:US
Practice Address - Phone:434-470-9171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306601388225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant