MEDICARE: SAMEERAH OWEN

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	225200000X	Physical Therapy Assistant	PTA003878	GA
2	225200000X	Physical Therapy Assistant	2066218	TX

General Provider Information

NPI Number	:	1295106185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMEERAH OWEN

Provider Business Mailing Address
First Line	:	1833 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-4021
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1833 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-4021
Country	:	US
Telephone Number	:	303-728-6500
Fax Number	:

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

Provider Enumeration Date	:	10/17/2015
Last Update Date	:	01/09/2026

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Directions to “ SAMEERAH OWEN ” Practice Location

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