Provider Demographics
NPI:1598077158
Name:SCHNEIDER, SAMANTHA JO (ATC)
Entity Type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:JO
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1819 BROOKHAVEN CIR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3191
Mailing Address - Country:US
Mailing Address - Phone:319-931-4063
Mailing Address - Fax:
Practice Address - Street 1:125 DECATUR ST SE
Practice Address - Street 2:GSU DEPT. OF ATHLETICS
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3201
Practice Address - Country:US
Practice Address - Phone:404-413-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-11
Last Update Date:2010-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer