Well Life With Sam, LLC
Clinic/Center, Medical Specialty in King George, VA. Organization (NPI-2).
NPI number1013715366
StatusActive
Last updated in NPPESMar 4, 2025
Details
- NPI
- 1013715366
- Entity type
- Organization (NPI-2)
- Legal business name
- Well Life With Sam, LLC
- Organization subpart
- No
- Enumeration date
- Mar 4, 2025
- Certification date
- Mar 4, 2025
- Last updated
- Mar 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | – | – | Yes |
Practice location
7935 Heron WayKing George, VA 22485-7391
Phone 217-202-5701
Mailing address
2003 Plank Rd # 1072Fredericksburg, VA 22401-5103
Phone 217-202-5701
Authorized official
Samantha Cogil
Nurse Practitioner/ Owner
2172025701
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