Individual
RANDY DALE MALAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
401 N 4TH ST, FIRST FLOOR, SPRINGFIELD, IL 62702-5255
(217) 785-8983
Mailing address
512 HUNTINGTON, GLEN CARBON, IL 62034-1952
(618) 288-4520
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
—
IL
Other
Enumeration date
07/01/2005
Last updated
07/08/2007
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