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General NPI Number Information
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NPI Number | 1013714823
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Entity Type | Individual
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Provider Name | SAMANTHA MARIE FRASER DPT
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Gender | Female
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 111 JAZIE DR STE E
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City | SAVANNAH
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State | GA
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Zip | 31410-1908
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Country | US
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Telephone | 912-898-7714
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Fax | 912-898-7715
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Provider Business Mailing Address
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Address Line | 111 JAZIE DR STE E
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City | SAVANNAH
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State | GA
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Zip | 31410-1908
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Country | US
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Telephone | 912-898-7714
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Fax | 912-898-7715
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT018144
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12772
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL26582
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License Number State | MA
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