Individual
KELSEY NICOLE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDMS
Contact information
Practice address
414 S BEELINE HWY STE 2, PAYSON, AZ 85541-4884
(928) 474-3582
(928) 832-1310
Mailing address
PO BOX 1247, PINE, AZ 85544-1247
(928) 595-2213
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
201891
AZ
Other
Enumeration date
04/08/2022
Last updated
04/08/2022
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