Individual
RANDALL BOHANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
640 E 700 S STE 3, ST GEORGE, UT 84770-4006
(435) 673-1004
Mailing address
51 W CENTER ST # 355, OREM, UT 84057-4605
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9394954-3102
UT
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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