Most Relevant Information
Provider Data
| NPI Number: | 1003589318 |
| Provider Name: | SAMANTHA R PORTER PT, DPT, LMT, CMTPT |
| Entity Type: | Individual |
| Taxonomy Code: | 2251X0800X |
| Specialty: | Physical Therapist |
| License Number: | 2021030538 |
Most Important Dates
| Enumeration Date: | 08/01/2021 |
| Last Updated: | 08/01/2021 |
Provider Practice Location
10407 CLAYTON RD
FRONTENAC
MO
631312909
Practice Location Phone/Fax
| Phone: | 3144326103 |
| Fax: |
Provider Mailing Location
9 STATESMAN CT
O FALLON
MO
633688502
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |