NPI 1861019804

Thomas Jack Sampson

Practitioner Nutritionist Menomonie, WI

Practice location

Address: 2021 Broadway St S, Menomonie, WI 54751-3950
Phone: (715) 308-3837

Registered specialties

Nutritionist Primary

Dietary & Nutritional Service Providers Taxonomy 133N00000X Licence 1124661

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Registry record

NPI: 1861019804
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jun 2020
Record last updated: 25 Jun 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.