Provider Demographics
NPI:1831557040
Name:ENGLUND, SAMANTHA (LMT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:ENGLUND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 SPELHAUG WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-2680
Mailing Address - Country:US
Mailing Address - Phone:907-687-1045
Mailing Address - Fax:
Practice Address - Street 1:455 3RD AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4737
Practice Address - Country:US
Practice Address - Phone:907-687-1045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist