Individual
SAMANTHA LEANN BIRMINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
556 JOHNSON ST, BOURBON, MO 65441-8123
(660) 227-9140
Mailing address
556 JOHNSON ST, BOURBON, MO 65441-8123
(660) 227-9140
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2019003773
MO
Other
Enumeration date
03/23/2022
Last updated
03/23/2022
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