Individual
MRS. NANCY TIDWELL RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 LEESTOWN RD, LEXINGTON, KY 40511-2136
(859) 259-0965
(859) 259-0971
Mailing address
1600 LEESTOWN RD, LEXINGTON, KY 40511-2136
(859) 259-0965
(859) 259-0971
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
008929
KY
Other
Enumeration date
07/31/2012
Last updated
07/31/2012
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