Individual
MR. RANDOLPH LEE STAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 W 78TH ST, SUITE 265, CHANHASSEN, MN 55317-8715
(952) 934-6000
(952) 934-6760
Mailing address
80 W 78TH ST, SUITE 265, CHANHASSEN, MN 55317-8715
(952) 934-6000
(952) 934-6760
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
E595041887419
MN
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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