Basic Information
| Provider Information | |||||||||
| NPI: | 1619526290 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUGGINS | ||||||||
| FirstName: | SAMANTHA | ||||||||
| MiddleName: | ANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2509 BORREGO DR | ||||||||
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| City: | DURANGO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 813015806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709465429 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2911 JUNCTION ST | ||||||||
| Address2: | |||||||||
| City: | DURANGO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 813014134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702472215 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2019 | ||||||||
| LastUpdateDate: | 09/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTL.0008447 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.