Individual
SAMANTHA JOANNE WHEELOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
139 MAIN ST, BETHEL, MN 55005-0136
(763) 269-8051
Mailing address
139 MAIN ST, BETHEL, MN 55005
(763) 269-8051
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1350
MN
Other
Enumeration date
01/03/2012
Last updated
01/03/2012
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