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General NPI Number Information
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NPI Number | 1679114409
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Entity Type | Organization
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Legal Business Name | SAMSON STRENGTH & PERFORMANCE PT
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 1074 10TH AVE S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-3306
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Country | US
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Telephone | 904-242-6905
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Fax |
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Provider Business Mailing Address
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Address Line | 313 COLORADO SPRINGS WAY
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32092-1929
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Country | US
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Telephone | 407-314-3465
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DELILAH BALDING
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Credential | DPT
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Telephone | 407-314-3465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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