Provider Demographics
NPI:1326931247
Name:DALES, SAMANTHA (DPT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:DALES
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 1:17636 INLET RD
Mailing Address - Street 2:
Mailing Address - City:CONNEAUTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16406-1622
Mailing Address - Country:US
Mailing Address - Phone:814-547-9988
Mailing Address - Fax:
Practice Address - Street 1:5930 OLD FRENCH RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-3656
Practice Address - Country:US
Practice Address - Phone:814-860-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATPT023960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist