Individual
SAMANTHA NICOLE ALTAMIRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(509) 307-7422
Mailing address
1149 DESOTO AVE, YPSILANTI, MI 48198-6279
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002102
MI
2255A2300X
Athletic Trainer
60865271
WA
2255A2300X
Athletic Trainer
AT005906
OH
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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