Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports |
NPI | 1437624947 |
---|---|
Provider Name | Samantha Vargo |
First Address | Perkasie, PA 18944-2371 |
Second Address | Hamden, CT 06518-1961 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2018 |
Last Update Date | 11/10/2018 |