MEDICARE: SAMANTHA BROOKE SELLERS D.C., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4661	NC
2	111NS0005X	Sports Physician Chiropractor	4661	NC

General Provider Information

NPI Number	:	1184076614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA BROOKE SELLERS D.C., M.S.

Provider Business Mailing Address
First Line	:	3948 BROWNING PL STE 110
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-6512
Country	:	US
Telephone Number	:	901-831-7234
Fax Number	:	919-480-2757

Provider Business Practice Location Address
First Line	:	3948 BROWNING PL STE 110
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-6512
Country	:	US
Telephone Number	:	901-831-7234
Fax Number	:	919-480-2757

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2016
Last Update Date	:	12/04/2024

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Directions to “ SAMANTHA BROOKE SELLERS D.C., M.S.” Practice Location

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