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Individual
SAMANTHA GENNO
Active
Individual
SAMANTHA GENNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2275
TN
2255A2300X
Athletic Trainer
AT002825
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000020078
BOC
—
Enumeration date
04/19/2016
Last updated
02/10/2021
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