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General NPI Number Information
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NPI Number | 1720893423
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Entity Type | Individual
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Provider Name | SAMANTHA BATES MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 800 GRAND CENTRAL MALL
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City | VIENNA
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State | WV
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Zip | 26105-4100
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Country | US
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Telephone | 304-485-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 800 GARFIELD AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-5376
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Country | US
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Telephone | 304-424-2111
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1502
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License Number State | WV
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