Samantha Paige Perry, MS, LAT, ATC

Individual provider Active NPI Athletic Trainer · Edmonton, KY

NPI 1487322368 · NPPES record last updated Sep 3, 2021

Key facts

NPI
1487322368
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
TCA966 (KY)
Practice address
208 Randolph St
Edmonton, KY 42129-8175
Phone
(270) 432-2481
NPI assigned
Sep 3, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
TCA966KYMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X TCA966 KY Yes

Addresses

Primary practice location

208 Randolph St
Edmonton, KY 42129-8175

Mailing address

1921 Sulphur Well Center Rd
Edmonton, KY 42129-8222
Phone (270) 670-5389

Other practice location 1

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone (270) 651-1111

Other providers in Edmonton, KY

All providers in Edmonton, KY · Athletic Trainer in Kentucky

Sources for this page

Verify at the official NPI Registry.