Healthcare Provider Details

I. General information

NPI: 1750799094
Provider Name (Legal Business Name): SAMANTHA FOSTER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 CLIFTON ST
LYNCHBURG VA
24501-1422
US

IV. Provider business mailing address

20347 TIMBERLAKE RD SUITE B
LYNCHBURG VA
24502-7203
US

V. Phone/Fax

Practice location:
  • Phone: 434-528-1848
  • Fax: 434-509-1695
Mailing address:
  • Phone: 434-845-9053
  • Fax: 434-528-2788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305208847
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: