Individual
ROBERT RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4200 N HOLTON ST STE 110, MILWAUKEE, WI 53212-1065
(414) 899-6838
Mailing address
4200 N HOLTON ST, MILWAUKEE, WI 53212-1008
(414) 899-6838
Taxonomy
Speciality
Code
Description
License number
State
163WP1700X
Perinatal Registered Nurse
Primary
163WP1700X
WI
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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