Individual
RANDY CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSE
Contact information
Practice address
600 RAILWAY ST N DEPT 266, FESSENDEN, ND 58438-7427
(701) 547-3694
(701) 547-3348
Mailing address
600 RAILWAY ST N DEPT 266, FESSENDEN, ND 58438-7427
(701) 547-3694
(701) 547-3348
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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