Provider Demographics
NPI:1730538083
Name:NOE, SAMANTHA (CSCS, ATC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:NOE
Suffix:
Gender:F
Credentials:CSCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WESTERN AVE
Mailing Address - Street 2:GE AVIATION HEALTH & WELLNESS CENTER
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905-2655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 WESTERN AVE
Practice Address - Street 2:GE AVIATION HEALTH & WELLNESS CENTER
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-2655
Practice Address - Country:US
Practice Address - Phone:978-434-1897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH06392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer