Provider Demographics
NPI:1174964688
Name:ZIMMERMANN, SAMANTHA EMILY (DPT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:EMILY
Last Name:ZIMMERMANN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 ENTERPRISE DR STE 16
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-2031
Mailing Address - Country:US
Mailing Address - Phone:603-210-9383
Mailing Address - Fax:603-894-6443
Practice Address - Street 1:55 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-2031
Practice Address - Country:US
Practice Address - Phone:603-210-9383
Practice Address - Fax:603-894-6443
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20364225100000X
NH3760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist