Individual
RANDALL SCOTT VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
537 BELLWOOD DR APT 1, ELIZABETHTOWN, KY 42701-2336
(270) 312-2500
Mailing address
537 BELLWOOD DR APT 1, ELIZABETHTOWN, KY 42701-2336
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1179634
KY
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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