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Individual
SAMUEL PEARSON
Active
Individual
SAMUEL PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208472
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154742724
MEDICAID QMB ONLY
VA
01
—
C05954
MEDICARE GROUP PTAN
VA
Enumeration date
12/26/2013
Last updated
05/27/2025
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