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General NPI Number Information
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NPI Number | 1659490910
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Entity Type | Individual
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Provider Name | RANDY ROMAN DC
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 2584 PATTERSON RD SUITE D
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City | GRAND JUNCTION
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State | CO
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Zip | 81505
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Country | US
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Telephone | 970-243-8896
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Fax | 970-245-1511
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Provider Business Mailing Address
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Address Line | 2584 PATTERSON RD SUITE D
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-1445
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Country | US
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Telephone | 970-243-8896
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Fax | 970-245-1511
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4818
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License Number State | CO
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