MEDICARE: SAMANTHA WITT DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT023184	PA

General Provider Information

NPI Number	:	1205267747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA WITT DPT

Provider Business Mailing Address
First Line	:	1691 BETHLEHEM PIKE
Second Line	:
City	:	HATFIELD
State	:	PA
Zip	:	19440-1302
Country	:	US
Telephone Number	:	267-308-5330
Fax Number	:	267-308-5331

Provider Business Practice Location Address
First Line	:	325 W GERMANTOWN PIKE
Second Line	:
City	:	EAST NORRITON
State	:	PA
Zip	:	19403-4207
Country	:	US
Telephone Number	:	267-534-7614
Fax Number	:	267-534-7615

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2013
Last Update Date	:	04/14/2023

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