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General NPI Number Information
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NPI Number | 1205645892
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Entity Type | Individual
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Provider Name | SAMANTHA ELISE ALLEN CNIM
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 9825 N 10800 W
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City | TREMONTON
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State | UT
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Zip | 84337-9222
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Country | US
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Telephone | 801-643-5057
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Fax |
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Provider Business Mailing Address
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Address Line | 890 E 3250 N
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City | OGDEN
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State | UT
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Zip | 84414-1773
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Country | US
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Telephone | 307-333-3161
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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 | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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