Basic Information
| Provider Information | |||||||||
| NPI: | 1548515950 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COMPTON-CRAIG | ||||||||
| FirstName: | SAMUEL | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10601 N MERIDIAN ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462901152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175752100 | ||||||||
| FaxNumber: | 3175752105 | ||||||||
| Practice Location | |||||||||
| Address1: | 10601 N MERIDIAN ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462901152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175752100 | ||||||||
| FaxNumber: | 3175752105 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2012 | ||||||||
| LastUpdateDate: | 05/02/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 05010902A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.