Individual
SAMANTHA MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2135 N RIDGE RD STE 200, WICHITA, KS 67212-1404
(316) 260-1128
Mailing address
810 N ASH ST, NEWTON, KS 67114-2630
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2022
Last updated
06/18/2022
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