MRS. Samantha A Mooberry, PA-C

NPI #1225411325 in Peoria, Illinois

Provider Information

NPI Number: 1225411325
Entity Type: Individual
Name: MRS. Samantha A Mooberry, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jul 7, 2015
Last Updated: Feb 26, 2019

Practice Location

Address: 530 NE GLEN OAK AVE
City: Peoria
State: Illinois
ZIP Code: 61637-0001
Phone: (309) 624-8818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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