Individual
SAMANTHA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1816 E 294TH ST, WICKLIFFE, OH 44092-1923
(440) 865-7911
Mailing address
1816 E 294TH ST, WICKLIFFE, OH 44092-1923
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
012552
OH
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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