MICHELLE RANDOLPH MD PC
Ambulatory Health at Laurel St, Anchorage, AK

License number
Alaska 7641
Category
Ambulatory Health
Type
Medical Specialty
Owner
Name: DR. MICHELLE LISA RANDOLPH M.D.
Title: PRESIDENT
Phone: (907) 562-2928
Address
Address
4048 Laurel St SUITE 301, Anchorage, AK 99508
National Provider ID: 1578806436
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Michelle Randolph, M.D., PC

4048 Laurel St, Anchorage, AK 99508

Registration:
Feb 4, 2013
State ID:
10010785
Business type:
Professional Corporation
Expiration:
Perpetual
Director, President, Shareholder, Secretary, Treasurer, Vice President:
Michelle Randolph (Director, President, Shareholder, Secretary, Treasurer, Vice President)
Agent:
Carolyn Heyman-Layne,500 L St, Anchorage, AK 99501 (Mailing)
Next Report:
20170102

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