Individual
THOMAS JACK SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2021 BROADWAY ST S, MENOMONIE, WI 54751-3950
(715) 308-3837
Mailing address
2021 BROADWAY ST S, MENOMONIE, WI 54751-3950
(715) 308-3837
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
1124661
—
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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