Provider Demographics
NPI:1134490303
Name:ZUEGE, SAMUEL VINCENT (ATC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:VINCENT
Last Name:ZUEGE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF LOUISVILLE
Mailing Address - Street 2:2770 S. FLOYD STREET
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40292-0001
Mailing Address - Country:US
Mailing Address - Phone:502-852-4746
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF LOUISVILLE
Practice Address - Street 2:2770 S. FLOYD ST.
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40292-0001
Practice Address - Country:US
Practice Address - Phone:502-852-4746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT8962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer