Provider Demographics
NPI:1740928258
Name:MATTIX, SAMANTHA A (PTA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:A
Last Name:MATTIX
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7198 PITTS BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039
Mailing Address - Country:US
Mailing Address - Phone:440-371-5215
Mailing Address - Fax:
Practice Address - Street 1:6765 STATE RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-4581
Practice Address - Country:US
Practice Address - Phone:440-577-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant