Individual
SAMANTHA DOTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3801 SPRING ST, MOUNT PLEASANT, WI 53405-1667
(262) 687-4201
Mailing address
3801 SPRING ST, RACINE, WI 53405
(262) 687-4201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3838-23
WI
Other
Enumeration date
05/27/2016
Last updated
03/15/2017
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