Provider Demographics
NPI:1285691600
Name:STEELE, SAMANTHA ANN (PTA)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:ANN
Last Name:STEELE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:AS
Other - Last Name:HOLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2364 APPLEGATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203
Mailing Address - Country:US
Mailing Address - Phone:812-374-2129
Mailing Address - Fax:
Practice Address - Street 1:2369 BEAM ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203
Practice Address - Country:US
Practice Address - Phone:812-378-4182
Practice Address - Fax:812-378-4194
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06003132A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant