| Doctor Name: | SAMUEL AARON INGRAM |
| NPI Number: | 1710009733 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 1166119 |
| Business Practice Address: | 7105 Mission Rd Prairie Village, KS - 662083077 |
| Business Phone Number: | 9132621611 |
| Business Fax Number: | |
| Mailing Address: | 12411 W 119th Ter Apt 618, OVERLAND PARK |
| State: | KS |
| Postal Code: | 662135725 |
| Phone Number: | 8172695971 |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 03/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1166119 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |