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1245848928
SAMANTHA DANIELLE KISAMORE
PETERSBURG, WV
NPI
1245848928
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
376K00000X Nurse's Aide
(Licence: WV 80681)
Enumeration Date
2020-07-17
Last Update Date
2020-07-17
Business Address
SAMANTHA DANIELLE KISAMORE
12 MAPLE HILL AVE STE 1
PETERSBURG, WV 26847-1547
Phone number: 304-257-9298
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Mailing Address
SAMANTHA DANIELLE KISAMORE
12 MAPLE HILL AVE STE 1
PETERSBURG, WV 26847-1547
Phone number: 304-257-9298
Copy