Individual
RANDOLPH WILLIAM G. FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DVM
Contact information
Practice address
21920 SE STARK ST, GRESHAM, OR 97030-2034
(503) 665-1109
(503) 666-3664
Mailing address
21920 SE STARK ST, GRESHAM, OR 97030-2034
(503) 665-1109
(503) 666-3664
Taxonomy
Speciality
Code
Description
License number
State
174M00000X
Veterinarian
Primary
4500
OR
Other
Enumeration date
07/01/2012
Last updated
07/01/2012
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