Randall Edward Pridgen LAT, ATC

NPI 1679641591 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1679641591
Gender Male
Enumeration Date 11/30/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
501 ROUNTREE ST W
WILSON NC, 27893-2811, US
Phone (252) 399-6520
Fax (252) 399-6516
Business Location
2102 CAMERON RD SW
WILSON NC, 27893-4502, US
Phone (252) 289-5005
Fax (252) 399-6516
Toxanomy
Taxonomy Code 2255A2300X
License State North Carolina
License Number 0328
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According to our database, Randall Edward Pridgen LAT, ATC NPI is 1679641591, taxonomy code is 2255A2300X and license number is 0328, license state is located at North Carolina. Randall Edward Pridgen LAT, ATC physically located at 501 Rountree St W, Wilson NC, 27893-2811. NPI Number Randall Edward Pridgen LAT, ATC has the Individual type.

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1679641591 NPI number is provided on an as is basis without warranty of any kind. 1679641591 is maintained by the National Plan & Provider Enumeration System. The contents of Randall Edward Pridgen LAT, ATC are for informational purposes only.