Individual
SAMANTHA THIEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06688
LA
Other
Enumeration date
11/21/2013
Last updated
11/21/2013
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