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NPI Code Detail

MEDICARE: CHRISTINE SAMSON PHD, LAT, ATC

MEDICARE: CHRISTINE SAMSON PHD, LAT, ATC
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 Trainer10826563-4810UT

General Provider Information

NPI Number : 1851940092
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE SAMSON PHD, LAT, ATC
Provider Business Mailing Address
First Line : 351 W UNIVERSITY BLVD
Second Line :
City : CEDAR CITY
State : UT
Zip : 84720-2415
Country : US
Telephone Number : 485-586-7822
Fax Number :
Provider Business Practice Location Address
First Line : 351 W UNIVERSITY BLVD
Second Line :
City : CEDAR CITY
State : UT
Zip : 84720-2415
Country : US
Telephone Number : 485-586-7822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2019
Last Update Date : 09/10/2019

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