NPI 1194547422

Randall Bennett

Practitioner Case Manager/Care Coordinator Lewiston, ID

Practice location

Address: 1720 18th Ave, Lewiston, ID 83501-4047
Phone: (208) 746-4097
Fax: (208) 746-2294

Registered specialties

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X

Other Case Manager/Care Coordinator providers in Idaho →

Registry record

NPI: 1194547422
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Oct 2024
Record last updated: 28 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.