Individual
SAMANTHA JO DRISCOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 23RD AVE, GREELEY, CO 80634-6070
(262) 331-4263
Mailing address
1600 23RD AVE, GREELEY, CO 80634-6070
(262) 331-4263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0073755
CO
390200000X
Student in an Organized Health Care Education/Training Program
1871282368
CO
Other
Enumeration date
05/02/2023
Last updated
10/06/2024
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