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Samuel Mario Barros

Physical Therapist in Conyers, GA. Individual provider (NPI-1).

NPI number1548045404
StatusActive
Last updated in NPPESAug 29, 2023

Details

NPI
1548045404
Entity type
Individual (NPI-1)
Name
Samuel Mario Barros
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 29, 2023
Certification date
Aug 29, 2023
Last updated
Aug 29, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist–GAYes
225100000X Physical TherapistPT38223FL

Practice location

1603 Georgia Highway 20 Ne Ste 201
Conyers, GA 30012-3946

Phone 770-929-8411

Mailing address

4846 Nw 107th Psge
Doral, FL 33178-4353

Phone 617-501-1433

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