Healthcare Provider Details
I. General information
NPI: 1487262549
Provider Name (Legal Business Name): SAMARA THERAPY SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2020
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1280 S 3RD ST W STE 1
MISSOULA MT
59801-2392
US
IV. Provider business mailing address
6740 PRAIRIE SCHOONER LN
MISSOULA MT
59808-5904
US
V. Phone/Fax
- Phone: 406-830-4500
- Fax: 406-258-0849
- Phone: 406-251-4774
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
A
GAERTIG
Title or Position: OWNER/MANAGER
Credential: DPT
Phone: 406-251-4774