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Individual

RANDALL L PAYNE

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
5 LAKEVIEW DR, WORDEN, IL 62097-1282
(618) 459-7142
Mailing address
5 LAKEVIEW DR, WORDEN, IL 62097-1282
(618) 459-7142

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Enumeration date
05/13/2006
Last updated
07/08/2007
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