RANDALL R SOUTHARDS

GREEN BAY, WI
NPI1841233186
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WI  1402)
Enumeration Date2006-06-14
Last Update Date2024-02-16
Business Address
RANDALL R SOUTHARDS PA
2845 GREENBRIER RD STE 320
GREEN BAY, WI 54311-6519
Phone number: 920-288-8320
Mailing Address
RANDALL R SOUTHARDS PA
2845 GREENBRIER RD STE 320 PO BOX 8900
GREEN BAY, WI 54308-8900
Phone number: 920-288-8320
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