Individual
SAMUEL JORDAN VELLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2982 HIGHWAY K, O FALLON, MO 63368-7861
(636) 978-9235
Mailing address
625 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-2395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2022043950
MO
Other
Enumeration date
05/23/2022
Last updated
02/11/2025
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