Individual
MR. RANDE LEE MALLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
305 GASKILL AVE, JEANNETTE, PA 15644-3333
(724) 396-9060
Mailing address
305 GASKILL AVE, JEANNETTE, PA 15644-3333
(724) 396-9060
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN519097L
PA
Other
Enumeration date
01/13/2010
Last updated
01/13/2010
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