Individual
GEORGE WILLIAM RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
703 W KING STREET, KINGS MOUNTAIN, NC 28086
(704) 739-7776
(704) 739-7776
Mailing address
703 W KING STREET, KINGS MOUNTAIN, NC 28086
(704) 739-7776
(704) 739-7776
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1865
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08687
BCBS
NC
01
—
5109252
AETNA
NC
05
—
8908687
—
NC
Enumeration date
08/23/2006
Last updated
07/08/2007
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