Healthcare Provider Details

I. General information

NPI: 1730324831
Provider Name (Legal Business Name): SAMANTHA K BROWN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAMANTHA K LEHECKA P.T

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 12/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EVERGREEN DR
EAST PROVIDENCE RI
02914-1503
US

IV. Provider business mailing address

35 ALLEN AVE
BARRINGTON RI
02806-1045
US

V. Phone/Fax

Practice location:
  • Phone: 401-438-3250
  • Fax:
Mailing address:
  • Phone: 713-550-6803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT02183
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1178340
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: