Individual
SAMANTHA MARIE BERTHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1466 BROAD ST, PROVIDENCE, RI 02905-2836
(401) 941-6221
Mailing address
9 OAK RIDGE DR, CUMBERLAND, RI 02864-3534
(401) 595-8695
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODTG00717
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2021
Last updated
06/25/2021
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