Most Relevant Information
Provider Data
| NPI Number: | 1003426180 |
| Provider Name: | SAMANTHA RAY WALTERS |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/04/2020 |
| Last Updated: | 08/04/2020 |
Provider Practice Location
41 REDBUD LN
ELKINS
WV
262411239
Practice Location Phone/Fax
| Phone: | 3046217738 |
| Fax: |
Provider Mailing Location
218 3RD ST
ELKINS
WV
262413833
Provider Mailing Phone/Fax
| Phone: | 3046365195 |
| Fax: |