Individual
DEONTE SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
7666 FULLERTON RD STE E, SPRINGFIELD, VA 22153-2818
(757) 975-7088
Mailing address
5914 COVERDALE WAY APT F, ALEXANDRIA, VA 22310-5407
(757) 975-7088
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019017993
VA
Other
Enumeration date
11/03/2025
Last updated
11/03/2025
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