Individual
MR. RANDY ALLEN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PROVIDER
Contact information
Practice address
212 WEST THIRD STREEET, 212 WEST THIRD STREET, BAINBRIDGE, OH 45612
(740) 634-2495
Mailing address
212 WEST THIRD STREEET, BAINBRIDGE, OH 45612
(740) 634-2495
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
2316621
OH
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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