Individual
CARLYN SAMUELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
7000 COLLEGE STATION DR, WILLIAMSBURG, KY 40769-1381
(606) 539-4369
Mailing address
PO BOX 321, DRAPER, VA 24324-0321
(540) 250-1445
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002487
VA
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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