MEDICARE: SAMANTHA HOLCOMB

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	5783	NC

General Provider Information

NPI Number	:	1588453328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA HOLCOMB

Provider Business Mailing Address
First Line	:	721 RUGBY RD
Second Line	:
City	:	LANCASTER
State	:	SC
Zip	:	29720-1751
Country	:	US
Telephone Number	:	336-225-8002
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 S MAIN ST
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28112-5541
Country	:	US
Telephone Number	:	704-420-3131
Fax Number	:

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

Provider Enumeration Date	:	05/06/2025
Last Update Date	:	05/06/2025

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Directions to “ SAMANTHA HOLCOMB ” Practice Location

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