Individual
JOHN WILSON RANDALL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
S.W.
Contact information
Practice address
210 POSTWOOD CT, MADISON, AL 35758-6620
(256) 520-5804
Mailing address
1838 N DIXIE HWY, FT LAUDERDALE, FL 33305-3829
(256) 520-5804
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1720C
AL
Other
Enumeration date
08/11/2013
Last updated
03/29/2018
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