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Individual

SAMANTHA HANCOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
10721 MAIN ST STE 200, FAIRFAX, VA 22030-6913
(703) 325-2620
(703) 352-2594
Mailing address
10721 MAIN ST STE 200, FAIRFAX, VA 22030-6913
(703) 352-2620

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004420
VA

Other

Enumeration date
11/06/2013
Last updated
11/01/2018
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