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Individual

SAMANTHA LEA ASHENBRENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
754 N COLLEGE RD, STE D, TWIN FALLS, ID 83301-5822
(208) 734-5313
(208) 736-1582
Mailing address
754 N COLLEGE RD, STE D, TWIN FALLS, ID 83301-5822
(208) 734-5313
(208) 736-1582

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3807
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1679953962
ID
01
P01582594
RR MEDICARE
ID
Enumeration date
06/02/2015
Last updated
07/19/2016
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