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Individual

MR. RANDEL JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2615 THREE OAKS RD, SUITE 2B, CARY, IL 60013-6127
(815) 260-4559
(847) 639-4192
Mailing address
2615 THREE OAKS RD, SUITE 2B, CARY, IL 60013-6127
(815) 260-4559
(847) 639-4192

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
227.001783
IL
225700000X
Massage Therapist
Primary
227.001783
IL

Other

Enumeration date
02/03/2015
Last updated
02/03/2015
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