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NPI Code Detail

MEDICARE: RANDALL MORTHLAND

MEDICARE: RANDALL MORTHLAND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor038005331IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346332681
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDALL MORTHLAND
Provider Business Mailing Address
First Line : 202 MAIN ST
Second Line :
City : SAVANNA
State : IL
Zip : 61074-1628
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 202 MAIN ST
Second Line :
City : SAVANNA
State : IL
Zip : 61074-1628
Country : US
Telephone Number : 815-273-4737
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 04/25/2011

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Directions to “ RANDALL MORTHLAND ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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