Individual
MARY E.G. RANDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5121 COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-4248
Mailing address
5121 COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-4248
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
2204274405
UT
Other
Enumeration date
12/22/2008
Last updated
12/22/2008
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