Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samantha Rose Jacoby, PTA

Individual provider Physical Therapy Assistant · NPI 1780187088

Samantha Rose Jacoby, PTA is a Physical Therapy Assistant in Mayville, Wisconsin. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

305 S Clark St
Mayville, WI 53050-1488
Phone: (920) 387-0354
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X

Record details

NPI number1780187088
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedMarch 13, 2018
Last updated in NPPESMarch 13, 2018

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