Randall, Glen
Randall, Glen is an individual health care provider with primary practice located at 1598 Delphic Way Ste A2 , Pocatello ID 83201-2200. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Randall, Glen can be contacted via phone (208) 232-0220.Contact Information
Primary practice address
1598 Delphic Way Ste A2
Pocatello ID 83201-2200
Phone: (208) 232-0220
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CHIA-912 | Idaho |
Profile Details
| NPI number | 1427083807 |
|---|---|
| LBN Legal business name | Randall, Glen |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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