Jenesis Samuels

NPI #1396340741 in Fairmont, West Virginia

Provider Information

NPI Number: 1396340741
Entity Type: Individual
Name: Jenesis Samuels
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Dec 3, 2020
Last Updated: Dec 3, 2020

Practice Location

Address: 200 BRADDOCK ST
City: Fairmont
State: West Virginia
ZIP Code: 26554-2208
Phone: (304) 534-0538

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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