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Individual

MR. RANDY LEE YASSEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CP CERT PROSTHETIST

Contact information

Practice address
234 OWEN DRIVE, TOTAL REHAB OTHOTICS & PROSTHETICS INC, FAYETTEVILLE, NC 28304
(910) 323-9016
(910) 486-8712
Mailing address
PO BOX 87067, FAYETTEVILLE, NC 28304
(910) 323-9016
(910) 486-8712

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7795106
NC
Enumeration date
09/21/2006
Last updated
04/26/2011
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