Individual
DR. RANDALL WAYNE LISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3315 BEMIDJI AVE N, BEMIDJI, MN 56601-4330
(218) 444-2225
(218) 444-7225
Mailing address
3315 BEMIDJI AVE N, BEMIDJI, MN 56601-4330
(218) 444-2225
(218) 444-7225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3170
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
78B72LI
BCBS
MN
Enumeration date
11/09/2006
Last updated
07/09/2007
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