Individual
LANDON RUNKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
221 S CHICAGO ST APT 8, MILFORD, IL 60953-1286
(779) 212-2762
Mailing address
221 S CHICAGO ST APT 8, MILFORD, IL 60953-1286
(779) 212-2762
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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