Individual
RANDALL A PENCE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4350 N 19TH AVE, SUITE #6, PHOENIX, AZ 85015-4602
(602) 264-9191
(602) 532-2973
Mailing address
4350 N 19TH AVE, SUITE #6, PHOENIX, AZ 85015-4602
(602) 264-9191
(602) 532-2973
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
AZ3194
AZ
Other
Enumeration date
08/24/2005
Last updated
07/08/2007
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