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Individual

ALICIA RANDLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6525 WINCHESTER HIGHLANDS DR, CANAL WINCHESTER, OH 43110-9475
(603) 915-3470
Mailing address
PO BOX 674, BRICE, OH 43109-0674
(603) 915-3470

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
2809018
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2809018
INDEPENDENT PROVIDER
OH
Enumeration date
07/18/2014
Last updated
07/18/2014
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