Provider Demographics
NPI:1073180303
Name:SATTLER, SAMANTHA R (PT)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:R
Last Name:SATTLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 S. LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801
Mailing Address - Country:US
Mailing Address - Phone:308-382-9700
Mailing Address - Fax:308-382-9898
Practice Address - Street 1:905 N CUSTER AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4304
Practice Address - Country:US
Practice Address - Phone:083-398-2170
Practice Address - Fax:308-398-5232
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2402225100000X
NE4204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist