Roger Lee Randall
Roger Lee Randall is a Massage Therapist in Boise, Idaho. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
960 S Broadway Ave Ste 200Boise, ID 83706-3667
Phone: (208) 433-9211
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Massage Therapist (primary) | Taxonomy 225700000X |
|---|
Record details
| NPI number | 1710617865 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 13, 2022 |
| Last updated in NPPES | June 13, 2022 |
| Certification date | June 13, 2022 |
| Mailing address | 16083 Sw Upper Boones Ferry Rd Ste 300, Portland, OR 97224-7736 |
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