Individual
SAMUEL TODD STAINBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
5604 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23462-5631
(757) 455-5000
Mailing address
801 PONCE CT, CHESAPEAKE, VA 23322-6897
(757) 376-3947
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605714
VA
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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