Individual
RANDALL MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
104 S FRONT AVE, PRESTONSBURG, KY 41653-1614
(606) 886-8572
(606) 886-4433
Mailing address
104 S FRONT AVE, PRESTONSBURG, KY 41653-1614
(606) 886-8572
(606) 886-4433
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1218DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77012185
—
KY
Enumeration date
09/23/2006
Last updated
08/27/2024
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