Individual
LAUREN RANDAZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 W MAIN ST, BELLEVILLE, IL 62226-6651
(618) 239-6222
Mailing address
2600 W MAIN ST, BELLEVILLE, IL 62226-6651
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004420
IL
Other
Enumeration date
04/20/2017
Last updated
04/20/2017
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