Individual
SAMANTHA MANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 NORTH AVE, GRAND JUNCTION, CO 81501-6428
(970) 242-0731
Mailing address
536 S MULBERRY ST APT 1, FRUITA, CO 81521-3205
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.0337667
CO
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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