Healthcare Provider Details

I. General information

NPI: 1962306845
Provider Name (Legal Business Name): SAMANTHA LYNNE EARLE DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3575 MAYBANK HWY STE D
JOHNS ISLAND SC
29455-4871
US

IV. Provider business mailing address

141 ATRIUM WAY
COLUMBIA SC
29223-6301
US

V. Phone/Fax

Practice location:
  • Phone: 843-352-4700
  • Fax: 843-352-6555
Mailing address:
  • Phone: 843-352-4700
  • Fax: 843-352-6555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13587
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: