RANDY ALLEN WHITE

BAINBRIDGE, OH
NPI1730300906
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy302F00000X Exclusive Provider Organization
(Licence: OH  2316621)
Enumeration Date2007-05-02
Last Update Date2007-07-08
Business Address
Mr. RANDY ALLEN WHITE PROVIDER
212 WEST THIRD STREEET 212 WEST THIRD STREET
BAINBRIDGE, OH 45612
Phone number: 740-634-2495
Mailing Address
Mr. RANDY ALLEN WHITE PROVIDER
212 WEST THIRD STREEET
BAINBRIDGE, OH 45612
Phone number: 740-634-2495