Randall Bennett

NPI #1194547422 in Lewiston, Idaho

Provider Information

NPI Number: 1194547422
Entity Type: Individual
Name: Randall Bennett
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Oct 28, 2024
Last Updated: Oct 28, 2024

Practice Location

Address: 1720 18TH AVE
City: Lewiston
State: Idaho
ZIP Code: 83501-4047
Phone: (208) 746-4097

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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