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Individual

SAMANTHA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT, ATC

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3960
ME
2255A2300X
Athletic Trainer
AT476
ME

Other

Enumeration date
11/04/2015
Last updated
03/06/2019
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