Individual
SAMANTHA PECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT, ATC
Contact information
Practice address
12020 COLUMBIA ST, BLAKELY, GA 39823-2598
(734) 347-8962
Mailing address
12020 COLUMBIA ST, BLAKELY, GA 39823-2598
(734) 347-8962
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT004041
GA
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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