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Individual

RANDY ROSENQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
2145 SOUTH AVE W, MISSOULA, MT 59801-6503
(406) 327-9200
(406) 327-0653
Mailing address
1700 N CHRISMAN RD, TRACY, CA 95304-9314
(800) 726-9180
(209) 834-1158

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
224P00000X
Prosthetist
Primary
225000000X
Orthotic Fitter

Other

Enumeration date
04/20/2011
Last updated
01/10/2012
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