Individual
SAMANTHA E VANDERBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
204 S SWEET GUM PL, BROKEN ARROW, OK 74012-4587
(918) 284-4220
(918) 249-2817
Mailing address
2608 W KENOSHA ST # 496, BROKEN ARROW, OK 74012-8952
(918) 284-4220
(918) 249-2817
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2928
OK
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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