Laura C. Randolph Md Sc

NPI 1255527727 - Clinic/Center - 261QM2500X

NPI Details
NPI 1255527727
Enumeration Date 09/19/2007
Last Updated 09/19/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name RITA RITA
Position OFFICE MANAGER
Phone (309) 664-6222
Fax (309) 664-5006
Practice Location
2502 E EMPIRE ST
SUITE C
BLOOMINGTON IL, 61704-3738, US
Phone (309) 664-6222
Fax (309) 664-5006
Business Location
2502 E EMPIRE ST
SUITE C
BLOOMINGTON IL, 61704-3738, US
Phone (309) 664-6222
Fax (309) 664-5006
Toxanomy
Taxonomy Code 261QM2500X
License State Illinois
License Number 36100030
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According to our database, Laura C. Randolph Md Sc NPI is 1255527727, taxonomy code is 261QM2500X and license number is 36100030, license state is located at Illinois. Laura C. Randolph Md Sc physically located at 2502 E Empire St, Bloomington IL, 61704-3738. NPI Number 1033115704 has the healthcare provider type.

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1255527727 NPI number is provided on an as is basis without warranty of any kind. 1255527727 is maintained by the National Plan & Provider Enumeration System. The contents of Laura C. Randolph Md Sc are for informational purposes only.