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General NPI Number Information
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NPI Number | 1073177705
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Entity Type | Individual
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Provider Name | SAM ADAM MASON DPT
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Gender | Male
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 923 GARLAND ST E
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City | WEST SALEM
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State | WI
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Zip | 54669-1331
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Country | US
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Telephone | 608-786-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 MISSISSIPPI ST
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City | LA CROSSE
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State | WI
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Zip | 54601-5074
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Country | US
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Telephone | 763-443-4020
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Fax |
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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 | 15113-24
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License Number State | WI
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