Provider Demographics
NPI:1588158521
Name:HARRIGAL, SAMANTHA (PT, DPT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:HARRIGAL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6694 BERESFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3743
Mailing Address - Country:US
Mailing Address - Phone:440-567-5875
Mailing Address - Fax:
Practice Address - Street 1:2655 W NATIONAL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-3617
Practice Address - Country:US
Practice Address - Phone:937-325-1531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017543225100000X
CAPT296390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist