Provider Demographics
NPI:1639560006
Name:RANDALL, MARGARET
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:RANDALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 EMERALD ST
Mailing Address - Street 2:UNIT J
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3611
Mailing Address - Country:US
Mailing Address - Phone:603-354-5422
Mailing Address - Fax:603-354-5423
Practice Address - Street 1:149 EMERALD ST
Practice Address - Street 2:UNIT J
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3611
Practice Address - Country:US
Practice Address - Phone:603-354-5422
Practice Address - Fax:603-354-5423
Is Sole Proprietor?:No
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH672156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician