Randolph Community Clinic Sc

NPI #1497832257 in Randolph, Wisconsin

Provider Information

NPI Number: 1497832257
Entity Type: Organization
Organization Name: Randolph Community Clinic Sc
Primary Specialty: Family Medicine
Enumeration Date: Nov 1, 2006
Last Updated: Apr 20, 2008

Practice Location

Address: 504 S HIGH STREET
City: Randolph
State: Wisconsin
ZIP Code: 53956
Phone: (920) 326-5060

Authorized Official

Name: MELISSA ELAINE LUCARELLI, MD
Title: PRESIDENT
Phone: (920) 326-5060

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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