Healthcare Provider Details

I. General information

NPI: 1891042388
Provider Name (Legal Business Name): SAMANTHA WOEHL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6281 TRI RIDGE BLVD SUITE 100
LOVELAND OH
45140-8345
US

IV. Provider business mailing address

2083 VALLEY FORGE DR APT. D
DAYTON OH
45440-3000
US

V. Phone/Fax

Practice location:
  • Phone: 866-791-5766
  • Fax:
Mailing address:
  • Phone: 937-409-1985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: