Provider Demographics
NPI:1558844803
Name:LANGENKAMP, SAMANTHA HOPE
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:HOPE
Last Name:LANGENKAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1254 ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-3712
Mailing Address - Country:US
Mailing Address - Phone:334-445-1380
Mailing Address - Fax:334-445-1489
Practice Address - Street 1:1254 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-3712
Practice Address - Country:US
Practice Address - Phone:334-445-1380
Practice Address - Fax:334-445-1489
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist