Provider Demographics
NPI:1881253367
Name:FITE, SAMANTHA MAE (LMT)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:MAE
Last Name:FITE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 UHRIG ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-1427
Mailing Address - Country:US
Mailing Address - Phone:937-402-4203
Mailing Address - Fax:937-402-4206
Practice Address - Street 1:111 UHRIG ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-1427
Practice Address - Country:US
Practice Address - Phone:937-402-4203
Practice Address - Fax:937-402-4206
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.022811225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist