SAMUEL A. SOUTHARD

APPLETON, WI
NPI1033561873
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: WI  167874-30)
Enumeration Date2016-07-05
Last Update Date2016-07-05
Business Address
-- SAMUEL A. SOUTHARD CRNA
1506 S ONEIDA ST
APPLETON, WI 54915-1305
Phone number: 920-738-2000
Mailing Address
-- SAMUEL A. SOUTHARD CRNA
PO BOX 8031
APPLETON, WI 54912-8031
Phone number: 866-313-0337
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