Individual
SAMUEL FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 MILLBRIDGE RD, LAUREL SPRINGS, NJ 08021-5508
(856) 883-1771
Mailing address
515 MILLBRIDGE RD, LAUREL SPRINGS, NJ 08021-5508
(856) 883-1771
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
STERILE
—
Enumeration date
11/09/2018
Last updated
11/09/2018
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