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Individual

MS. SAMANTHA ANNE MOLONY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
1400 A O JONES BLVD, FORT MILL, SC 29715-1625
(803) 835-0024
Mailing address
171 CLEGGAN RD APT 305, ROCK HILL, SC 29730-5879
(843) 478-1151

Taxonomy

Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
2166
SC
2080S0010X
Pediatric Sports Medicine Physician
LAT-3146
NC

Other

Enumeration date
06/04/2020
Last updated
06/04/2020
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