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Individual

JOSH RANDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1126 WESTRAC DR S, FARGO, ND 58103-2342
(701) 412-2973
(701) 237-4407
Mailing address
891 BELSLY BLVD, MOORHEAD, MN 56560-5055
(218) 287-4338
(218) 287-5928

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
ND

Other

Enumeration date
10/18/2016
Last updated
10/18/2016
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