Healthcare Provider Details

I. General information

NPI: 1437946969
Provider Name (Legal Business Name): PATRICK SAMPSEL PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6099 RIVERSIDE DR STE 207
DUBLIN OH
43017-2004
US

IV. Provider business mailing address

6011 CORK COUNTY DR
GALLOWAY OH
43119-9109
US

V. Phone/Fax

Practice location:
  • Phone: 740-953-1184
  • Fax:
Mailing address:
  • Phone: 937-209-0062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA011273
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: