Healthcare Provider Details

I. General information

NPI: 1386988798
Provider Name (Legal Business Name): SAMANTHA AMATEIS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1591 PORT REPUBLIC RD
HARRISONBURG VA
22801-3517
US

IV. Provider business mailing address

44 N WILLOW ST
HARRISONBURG VA
22802-2021
US

V. Phone/Fax

Practice location:
  • Phone: 540-437-4226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119005779
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: