Provider Demographics
NPI:1700578408
Name:LEMMINGER, SAMANTHA CHRISTINE (PT)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:CHRISTINE
Last Name:LEMMINGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 PETERS DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-8707
Mailing Address - Country:US
Mailing Address - Phone:414-813-4646
Mailing Address - Fax:
Practice Address - Street 1:2020 S COLLEGE AVE UNIT C
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1464
Practice Address - Country:US
Practice Address - Phone:970-430-7055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist