Samuel Allen Bartrom
Student in an Organized Health Care Education/Training Program in La Fontaine, IN. Individual provider (NPI-1).
NPI number1295570042
StatusActive
Last updated in NPPESJun 25, 2024
Details
- NPI
- 1295570042
- Entity type
- Individual (NPI-1)
- Name
- Samuel Allen Bartrom
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 25, 2024
- Certification date
- Jun 25, 2024
- Last updated
- Jun 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
Po Box 22La Fontaine, IN 46940-0022
Phone 574-215-9384
Mailing address
Po Box 22La Fontaine, IN 46940-0022
Phone 574-215-9384
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