Individual
SUZANNE MARIE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
439 E DRINKER ST, DUNMORE, PA 18512-2483
(570) 955-5435
Mailing address
439 E DRINKER ST, DUNMORE, PA 18512-2483
(570) 955-5435
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
MSG010857
PA
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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