Individual ProviderSamantha KligDietitian, RegisteredDietary & Nutritional Service ProvidersPractice Address110 Irving St NW, Washington, DC 20010-3017(202) 877-7710(410) 830-0592PECOS EnrollmentBased on the most recent information from CMS, provider Samantha Klig does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1396367660Provider TypeIndividualFull NameKlig, SamanthaCredentialRDGenderFemaleSole ProprietorNoEnumeration Date5/10/2020Last Updated5/10/2020Contact InformationPractice LocationPractice Address110 Irving St NW, Washington, DC 20010-3017Phone(202) 877-7710FaxUnlisted FaxMailing LocationMailing Address2302 Long Ridge Rd, Reisterstown, MD 21136-5677Phone(410) 830-0592FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode133V00000XPrimaryDescriptionDietitian, RegisteredDietary & Nutritional Service ProvidersLicenseDI100001083District of Columbia