Individual
MS. TARA KAY RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSRDLDCDE
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-2736
(573) 302-2755
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-2736
(573) 302-2755
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2005032486
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528081288
NPI
MO
Enumeration date
07/25/2006
Last updated
06/09/2010
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