MELISA RANDALL

BOISE, ID
NPI1427782549
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-2359)
Additional Taxonomies2471C3402X Radiologic Technologist, Radiography
(Licence: ID  583626)
Enumeration Date2022-07-13
Last Update Date2022-10-11
Business Address
MELISA RANDALL PA
222 N 2ND ST STE 204
BOISE, ID 83702-6130
Phone number: 208-429-9100
Mailing Address
MELISA RANDALL PA
222 N 2ND ST STE 204
BOISE, ID 83702-6130
Phone number: 208-429-9100