Individual
LEILA RANDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3441 S GLASGOW CIR, BLOOMINGTON, IN 47403-7902
(812) 822-0228
Mailing address
3441 S GLASGOW CIR, BLOOMINGTON, IN 47403-7902
(812) 822-0228
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
8932-53-0103
IN
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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