Individual
RANDALL SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHS, LRT/CTRS
Contact information
Practice address
121 SHILOH RD, ASHEVILLE, NC 28803-1626
(828) 277-1315
Mailing address
PO BOX 802, ASHEVILLE, NC 28802-0802
(828) 277-1315
(828) 277-1321
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
1448
NC
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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