Samantha Nicole Altamirano, ATC

Individual provider Active NPI Athletic Trainer · Jackson, MI

NPI 1285206136 · NPPES record last updated Jul 12, 2021

Key facts

NPI
1285206136
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2601002102 (MI)
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(509) 307-7422
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2601002102MIMDAthletic Trainer
AT005906OHMDAthletic Trainer
60865271WAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT005906 OH
Athletic Trainer 2255A2300X 60865271 WA
Athletic Trainer 2255A2300X 2601002102 MI Yes

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

1149 Desoto Ave
Ypsilanti, MI 48198-6279

Other names

  • Samantha Nicole McTee Former name

Other providers in Jackson, MI

All providers in Jackson, MI · Athletic Trainer in Michigan

Sources for this page

Verify at the official NPI Registry.