Provider Demographics
NPI:1033416201
Name:PLANCK, RANDALL LEE II (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:LEE
Last Name:PLANCK
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5344 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-2704
Mailing Address - Country:US
Mailing Address - Phone:704-940-4000
Mailing Address - Fax:704-940-4001
Practice Address - Street 1:5344 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-2704
Practice Address - Country:US
Practice Address - Phone:704-940-4000
Practice Address - Fax:704-940-4001
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4169111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor