Individual
MS. SAMANTHA JO MODDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,DPT
Contact information
Practice address
1234 WHITEFISH STAGE, KALISPELL, MT 59901-2753
(406) 756-7878
(406) 257-7811
Mailing address
1234 WHITEFISH STAGE ROAD, KALISPELL, MT 59901-2753
(406) 756-7878
(406) 257-7811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2439
MT
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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