Individual
MR. COREY JEFFREY SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1033 BASIN AVE, BISMARCK, ND 58504-6649
(701) 223-6613
Mailing address
300 N 31ST ST APT 40, BISMARCK, ND 58501-5101
(701) 570-3480
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1474
ND
Other
Enumeration date
12/18/2007
Last updated
12/20/2007
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