Individual
KATIE NICOLE SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1685 W 2200 S, SALT LAKE CITY, UT 84119-1456
(801) 478-7780
Mailing address
4725 S 1300 E APT 21, MILLCREEK, UT 84117-5099
(801) 413-8868
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-30440
AZ
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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