Provider Demographics
NPI:1407085384
Name:TUTTERROW, SAMANTHA WALKER (DPT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:WALKER
Last Name:TUTTERROW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 RIDGELAND PKWY
Mailing Address - Street 2:200
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-0728
Mailing Address - Country:US
Mailing Address - Phone:770-663-6595
Mailing Address - Fax:770-663-6516
Practice Address - Street 1:1335 RIDGELAND PKWY
Practice Address - Street 2:200
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-0728
Practice Address - Country:US
Practice Address - Phone:770-663-6595
Practice Address - Fax:770-663-6516
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009652225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist