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NPI Code Detail

MEDICARE: SAMANTHA MICHELLE HOWELL MS, ATC, LAT

MEDICARE: SAMANTHA MICHELLE HOWELL MS, ATC, LAT
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1275147761
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA MICHELLE HOWELL MS, ATC, LAT
Provider Business Mailing Address
First Line : 6525 DEANE HILL DR APT 26
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-6009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1551 LAKE LOUDON BLVD OFC A111
Second Line :
City : KNOXVILLE
State : TN
Zip : 37916-4009
Country : US
Telephone Number : 540-521-2842
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2020
Last Update Date : 09/02/2020

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