Provider Demographics
NPI:1972227817
Name:ALTLAND, SAMANTHA LEE (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:LEE
Last Name:ALTLAND
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 S MAIN ST APT G
Mailing Address - Street 2:
Mailing Address - City:JACOBUS
Mailing Address - State:PA
Mailing Address - Zip Code:17407-1306
Mailing Address - Country:US
Mailing Address - Phone:570-229-1421
Mailing Address - Fax:
Practice Address - Street 1:820 CHAMBERSBURG RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-3310
Practice Address - Country:US
Practice Address - Phone:717-337-4206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018769225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist