MEDICARE: SAMANTHA PHILLIPS

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	13061	SC

General Provider Information

NPI Number	:	1770463457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA PHILLIPS

Provider Business Mailing Address
First Line	:	25620 FRIENDSHIP RD
Second Line	:
City	:	DAPHNE
State	:	AL
Zip	:	36526-6022
Country	:	US
Telephone Number	:	251-270-1551
Fax Number	:	251-270-1552

Provider Business Practice Location Address
First Line	:	309 W LAUREL AVE
Second Line	:
City	:	FOLEY
State	:	AL
Zip	:	36535-1974
Country	:	US
Telephone Number	:	251-270-1551
Fax Number	:

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

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	09/10/2025

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Directions to “ SAMANTHA PHILLIPS ” Practice Location

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