Provider Demographics
NPI:1184279168
Name:STRATTON, SAMUEL (DPT)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:STRATTON
Suffix:
Gender:M
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:PO BOX 639353
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9353
Mailing Address - Country:US
Mailing Address - Phone:812-537-8241
Mailing Address - Fax:812-537-1041
Practice Address - Street 1:476 W US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:IN
Practice Address - Zip Code:47042-8536
Practice Address - Country:US
Practice Address - Phone:812-689-1771
Practice Address - Fax:812-689-1778
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012910A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist