MR. Wayne George Randall

NPI #1760782726 in Coquille, Oregon

Provider Information

NPI Number
1760782726
Entity Type
Individual
Name
MR. Wayne George Randall
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Specialist
Enumeration Date
Oct 25, 2010
Last Updated
Oct 25, 2010

Practice Location

Address
364 N CENTRAL BLVD
State
Oregon
ZIP Code
97423-1244
Phone
(541) 396-4283

Specialties & Taxonomy Codes

Specialty
Specialist

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