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1194547422
RANDALL BENNETT
LEWISTON, ID
NPI
1194547422
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2024-10-28
Last Update Date
2024-10-28
Business Address
RANDALL BENNETT
1720 18TH AVE
LEWISTON, ID 83501-4047
Phone number: 208-746-4097
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Mailing Address
RANDALL BENNETT
1720 18TH AVE
LEWISTON, ID 83501-4047
Phone number: 208-746-4097
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