Provider Demographics
NPI:1366003642
Name:DOLCH, SAMANTHA (DPT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:DOLCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:ROSKAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1519 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4612
Mailing Address - Country:US
Mailing Address - Phone:443-926-1005
Mailing Address - Fax:
Practice Address - Street 1:2900 S HANOVER ST STE 102
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1232
Practice Address - Country:US
Practice Address - Phone:410-350-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation