# WELL LIFE WITH SAM, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013715366
- **Authorized official:** SAMANTHA COGIL NP (NURSE PRACTITIONER/ OWNER)
- **Authorized official phone:** (217) 202-5701

## Contact information

- **Practice address:** 7935 HERON WAY, KING GEORGE, VA 22485-7391
- **Practice address phone:** (217) 202-5701
- **Mailing address:** 2003 PLANK RD \# 1072, FREDERICKSBURG, VA 22401-5103
- **Mailing address phone:** (217) 202-5701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/04/2025
- **Last updated:** 03/04/2025