| NPI | 1194069625 |
|---|---|
| Former Name | SAMANTHA ANN PEABODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 3845) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MA 20312) |
| 225100000X Physical Therapist (Licence: MA 20312) | |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2015-11-20 |