Individual
SAMANTHA WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11506 NICHOLAS ST, SUITE 110, OMAHA, NE 68154-4407
(800) 230-3885
(402) 505-9753
Mailing address
640 NIAGARA FALLS BLVD, TONAWANDA, NY 14223-2232
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4122
NM
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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