Individual
AMANDA RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 S WILLOW AVE, COOKEVILLE, TN 38501-3727
(931) 525-6240
Mailing address
5058 BURGESS FALLS RD, BAXTER, TN 38544-5319
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
41090
TN
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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