Individual
SAMANTHA LEE FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHA, LAT, ATC
Contact information
Practice address
518 W LOCUST ST, DAVENPORT, IA 52803-2898
(815) 303-9909
Mailing address
2011 46TH ST, ROCK ISLAND, IL 61201-4919
(815) 303-9909
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
001165
IA
2255A2300X
Athletic Trainer
096004831
IL
2255A2300X
Athletic Trainer
Primary
2013030176
MO
Other
Enumeration date
10/09/2014
Last updated
03/13/2023
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