MR. Randy Allen White, PROVIDER
NPI #1730300906 in Bainbridge, Ohio
Provider Information
- NPI Number
- 1730300906
- Entity Type
- Individual
- Name
- MR. Randy Allen White, PROVIDER
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Exclusive Provider Organization
- Credential
- PROVIDER
- Enumeration Date
- May 2, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 212 WEST THIRD STREEET
- Address 2
- 212 WEST THIRD STREET
- City
- Bainbridge
- State
- Ohio
- ZIP Code
- 45612
- Phone
- (740) 634-2495
Specialties & Taxonomy Codes
| Specialty |
|---|
| Exclusive Provider Organization |
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