| NPI | 1700979614 |
|---|---|
| Doing Business As | RANDOLPH FAMILY PRACTICE CLINIC |
| Entity Type | Organization |
| Authorized Contact | LON M. KNIEVEL CEO 402-748-3393 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-11-23 |