Individual
SAMANTHA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPM, LAT, ATC
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 897-8100
Mailing address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
36001940A
IN
2255A2300X
Athletic Trainer
AT.004339
OH
2255A2300X
Athletic Trainer
Primary
—
KY
Other
Enumeration date
08/05/2014
Last updated
05/30/2026
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