Individual
ROBERTA RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
365 S CROWN HILL RD, ORRVILLE, OH 44667-9527
(330) 452-9911
Mailing address
2600 SIXTH ST SW, CANTON, OH 44710-1702
(330) 452-9911
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
496403
OH
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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