MEDICARE: SAMANTHA DEWEES

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	PT030564	PA

General Provider Information

NPI Number	:	1205564804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA DEWEES

Provider Business Mailing Address
First Line	:	1510 9TH AVE
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-2417
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 9TH AVE
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-2417
Country	:	US
Telephone Number	:	814-889-3900
Fax Number	:

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

Provider Enumeration Date	:	08/11/2022
Last Update Date	:	08/11/2022

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Directions to “ SAMANTHA DEWEES ” Practice Location

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