Individual
SUSAN JEAN MATSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1407 SAINT ANDREW ST STE 100, LA CROSSE, WI 54603-2378
(608) 785-6266
Mailing address
W19140 SAWMILL ROAD, GALESVILLE, WI 54630
(608) 582-2529
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
66760-30
WI
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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