Gary Randall

NPI #1962818740 in Pocatello, Idaho

Provider Information

NPI Number: 1962818740
Entity Type: Individual
Name: Gary Randall
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Enumeration Date: Jul 1, 2014
Last Updated: Jul 1, 2014

Practice Location

Address: 209 E LEWIS ST
City: Pocatello
State: Idaho
ZIP Code: 83201-6465
Phone: (208) 233-7693

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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