Provider Demographics
NPI:1548515950
Name:COMPTON-CRAIG, SAMUEL JOSEPH (DPT)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:JOSEPH
Last Name:COMPTON-CRAIG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10601 N MERIDIAN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1152
Mailing Address - Country:US
Mailing Address - Phone:317-575-2100
Mailing Address - Fax:317-575-2105
Practice Address - Street 1:10601 N MERIDIAN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46290-1152
Practice Address - Country:US
Practice Address - Phone:317-575-2100
Practice Address - Fax:317-575-2105
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010902A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist