Healthcare Provider Details
I. General information
NPI: 1124919949
Provider Name (Legal Business Name): SAMANTHA QUINN TARNOWSKI PT, DPT
Entity Type: Individual
Gender:
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/10/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 HIGHLAND CENTER DR STE B
COLUMBIA SC
29203-9247
US
IV. Provider business mailing address
655 S WILLOW ST STE 128
MANCHESTER NH
03103-5723
US
V. Phone/Fax
- Phone: 803-699-9775
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | CP049797T |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | CP046569T |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: