Individual
MRS. PAIGE RAE SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
801 N BROADWAY, FARGO, ND 58122
(701) 234-2000
Mailing address
411 1ST AVE SE, ROTHSAY, MN 56579
(218) 251-3119
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2003
MN
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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