Healthcare Provider Details

I. General information

NPI: 1023474699
Provider Name (Legal Business Name): SAMANTHA STEELE ATC, OTC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2016
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11140 MONTGOMERY RD
CINCINNATI OH
45249-2309
US

IV. Provider business mailing address

11140 MONTGOMERY RD
CINCINNATI OH
45249-2309
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-5200
  • Fax:
Mailing address:
  • Phone: 513-791-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.004618
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code246ZX2200X
TaxonomyOrthopedic Assistant
License Number18-0922
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: