Provider Demographics
NPI:1083954564
Name:WHEELER, SAMANTHA H (DPT)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:H
Last Name:WHEELER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:H
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2680 VALLEYDALE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2023
Mailing Address - Country:US
Mailing Address - Phone:205-981-1690
Mailing Address - Fax:205-981-1692
Practice Address - Street 1:2050 VILLAGE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:LEEDS
Practice Address - State:AL
Practice Address - Zip Code:35094-1107
Practice Address - Country:US
Practice Address - Phone:205-640-1088
Practice Address - Fax:205-640-7009
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist