Individual
MR. RANDY LEROY ST.PIERRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAS MLT (ASCP)
Contact information
Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2229
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2229
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
MLT 51091
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5549050
—
SD
Enumeration date
02/10/2010
Last updated
02/10/2010
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