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General NPI Number Information
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NPI Number | 1508304015
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Entity Type | Individual
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Provider Name | SAMANTHA GETZ
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Gender | Female
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 3706 KNOLLRIDGE RD.
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City | SALEM
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State | VA
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Zip | 24153
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Country | US
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Telephone | 540-314-6320
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Fax |
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Provider Business Mailing Address
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Address Line | 5121 MEADOW VALLEY CIRCLE
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City | ROANOKE
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State | VA
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Zip | 24018
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Country | US
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Telephone | 540-314-6320
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 0119003494
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License Number State | VA
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