Individual
SAMANTHA KRACKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1229 COUNTY FARM RD, BEDFORD, VA 24523-3131
(540) 586-7658
Mailing address
1369 CLARKE AVE SW # B, ROANOKE, VA 24016-4901
(540) 892-6248
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119-009039
VA
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
04/28/2021
Last updated
05/17/2021
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