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1104532225
SAMANTHA DEE HENDRICKSON
PROVO, UT
NPI
1104532225
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: UT 11125787-4810)
Enumeration Date
2023-01-24
Last Update Date
2023-01-24
Business Address
SAMANTHA DEE HENDRICKSON LAT, ATC
1000 NORTH UNIVERSITY AVENUE
PROVO, UT 84604
Phone number: 801-422-4636
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Mailing Address
SAMANTHA DEE HENDRICKSON LAT, ATC
1254 N 350 W
AMERICAN FORK, UT 84003-5187
Phone number:
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