Individual
KENYATTE RASHEND SAMPSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3009 W FLETCHER ST, PHILADELPHIA, PA 19132-3427
(856) 842-6493
Mailing address
3113 W DAKOTA ST, PHILADELPHIA, PA 19132-3313
(856) 842-6493
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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