Individual
SAMANTHA JO RUNSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1101 LAKE AVE W, LADYSMITH, WI 54848-1062
(920) 496-4700
Mailing address
719 W HAMILTON AVE STE B, EAU CLAIRE, WI 54701-6970
(715) 552-9784
(715) 835-6370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
72388-20
WI
Other
Enumeration date
04/23/2018
Last updated
03/07/2024
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