Individual
SAMANTHA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8100 PALOMAS AVE NE, ALBUQUERQUE, NM 87109-5264
(505) 821-4200
(505) 822-0234
Mailing address
1212 S MONTEREY AVE TRLR 19, FARMINGTON, NM 87401-6681
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1345
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1345
PTA
NM
Enumeration date
06/25/2018
Last updated
06/25/2018
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