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Randall Bennett

NPI 1194547422 · on the registry since 2024

Practice

Address: 1720 18th Ave
Lewiston, ID 83501
Phone: (208) 746-4097
Fax: (208) 746-2294
Organisation at this address: Phil Waggoner
Riverside Recovery Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 18

Registry record

Primary taxonomy: Case Manager/Care Coordinator
171M00000X
Sex: Male
Record last updated: 2024-10-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho