Jeffrey Dwayne Randall MPC

NPI 1376688796 - Counselor - 101YM0800X

NPI Details
NPI 1376688796
Gender Male
Enumeration Date 02/21/2007
Last Updated 09/18/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
501 HIGHWAY 90 E
LITTLE RIVER SC, 29566-9261, US
Phone (803) 422-7231
Fax
Business Location
501 HIGHWAY 90 E
LITTLE RIVER SC, 29566, US
Phone (803) 422-7231
Fax
Toxanomy
Taxonomy Code 101YM0800X
License State
License Number
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According to our database, Mr. Jeffrey Dwayne Randall MPC NPI is 1376688796, taxonomy code is 101YM0800X Jeffrey Dwayne Randall MPC physically located at 501 Highway 90 E, Little River SC, 29566-9261. NPI Number Jeffrey Dwayne Randall MPC has the Individual type.

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1376688796 NPI number is provided on an as is basis without warranty of any kind. 1376688796 is maintained by the National Plan & Provider Enumeration System. The contents of Jeffrey Dwayne Randall MPC are for informational purposes only.