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General NPI Number Information
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NPI Number | 1710560578
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Entity Type | Individual
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Provider Name | SAMANTHA INDIGARO PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 04/29/2021
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 140 DIAMOND CREEK PL
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City | ROSEVILLE
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State | CA
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Zip | 95747-6652
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Country | US
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Telephone | 916-206-3612
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Fax |
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Provider Business Mailing Address
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Address Line | 140 DIAMOND CREEK PL STE 125
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City | ROSEVILLE
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State | CA
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Zip | 95747-6654
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Country | US
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Telephone | 408-813-2812
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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 | 22819
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License Number State | MA
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