Provider Demographics
NPI:1447023866
Name:WINSLETT, SAMANTHA M (DPT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:M
Last Name:WINSLETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1650 LYNDON FARM CT STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5005
Mailing Address - Country:US
Mailing Address - Phone:502-882-9379
Mailing Address - Fax:502-587-5728
Practice Address - Street 1:132 FRONTIER BLVD STE 106
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-6516
Practice Address - Country:US
Practice Address - Phone:606-257-0005
Practice Address - Fax:606-262-4132
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY008980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist