Samantha Cole, LMT
Individual provider Active NPI Massage Therapist · Hart, MI
NPI 1407201106 · NPPES record last updated Apr 30, 2016
Key facts
- NPI
- 1407201106
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 7501003007 (MI)
- Practice address
- 601 E Main St
Hart, MI 49420-1144 - Phone
- (231) 873-3577
- Fax
- (231) 873-3557
- NPI assigned
- Apr 30, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7501003007 | MI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Michigan, LLC | Past |
Accepting new patients | |
| Lakeside Comprehensive Rehabilitation Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 7501003007 | MI | Yes |
Addresses
Primary practice location
601 E Main St
Hart, MI 49420-1144
Mailing address
601 E Main St
Hart, MI 49420-1144
Phone (231) 873-3577
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7501003007 | Other | MI | LICENSE NUMBER |
Other providers in Hart, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.