# SAMANTHA CHILSON, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194518365
- **Authorized official:** SAMANTHA CHILSON (OWNER)
- **Authorized official phone:** (636) 358-9612

## Contact information

- **Practice address:** 400 LAKE SAINT LOUIS BLVD, LAKE SAINT LOUIS, MO 63367-1377
- **Practice address phone:** (636) 358-9612
- **Mailing address:** 142 DIEKAMP LN, SAINT CHARLES, MO 63303-5137

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/28/2025
- **Last updated:** 05/28/2025