Provider Demographics
NPI:1902912702
Name:KRUMM, RANDALL R (DC)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:R
Last Name:KRUMM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-0687
Mailing Address - Country:US
Mailing Address - Phone:740-533-0550
Mailing Address - Fax:740-534-1111
Practice Address - Street 1:2301 S 7TH ST STE 3
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-2542
Practice Address - Country:US
Practice Address - Phone:740-533-0550
Practice Address - Fax:740-534-1111
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2212340Medicaid
OH2212340Medicaid
OH4017091Medicare PIN