Individual
NORMA NAOMI RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1832 DELLA DR, DAYTON, OH 45417-4524
(937) 979-2926
Mailing address
1832 DELLA DR, DAYTON, OH 45417-4524
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
TB022384
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OHIO
—
OH
Enumeration date
10/05/2019
Last updated
10/05/2019
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