Randall, Russell James
Randall, Russell James is an individual health care provider with primary practice located at 227 Colfax Avenue , Grass Valley CA 95945. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Randall, Russell James can be contacted via phone (530) 273-7988.Contact Information
Primary practice address
227 Colfax Avenue
Grass Valley CA 95945
Phone: (530) 273-7988
Fax: (530) 273-7993
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | DC0109140 | California |
Profile Details
| NPI number | 1104988591 |
|---|---|
| LBN Legal business name | Randall, Russell James |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 14th, 2006 |
| Last updated | Aug 24th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104988591 | NPPES |
| California | MEDICAID | 0109140 |
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