Individual
SAMANTHA JO SALOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1129633
IA
207Q00000X
Family Medicine Physician
1129633
WI
363LF0000X
Family Nurse Practitioner
11296-33
WI
363LP2300X
Primary Care Nurse Practitioner
Primary
A164679
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235808585
—
WI
Enumeration date
09/09/2021
Last updated
07/22/2022
Update your record
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