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Individual

SAMANTHA G SPAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
1710 KERNERSVILLE MEDICAL PKWY STE 101, KERNERSVILLE, NC 27284-7156
(336) 564-4950
(336) 564-4959
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 564-4950
(336) 564-4959

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L004914
NC

Other

Enumeration date
06/28/2016
Last updated
10/26/2020
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