Provider Demographics
NPI:1487262549
Name:SAMARA THERAPY SPECIALISTS PLLC
Entity type:Organization
Organization Name:SAMARA THERAPY SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAERTIG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:406-251-4774
Mailing Address - Street 1:6740 PRAIRIE SCHOONER LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-5904
Mailing Address - Country:US
Mailing Address - Phone:406-251-4774
Mailing Address - Fax:
Practice Address - Street 1:1280 S 3RD ST W STE 1
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-2392
Practice Address - Country:US
Practice Address - Phone:406-830-4500
Practice Address - Fax:406-258-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1104139567Medicaid