Individual
MRS. SANDRA IL RUNYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 2 BOX 310, WILLIAMSON, WV 25661-9679
(304) 235-3333
Mailing address
RR 1 BOX 174, WILLIAMSON, WV 25661-9728
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
47698
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810009009
—
WV
Enumeration date
01/18/2008
Last updated
01/18/2008
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