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Individual
MS. MICHELE T RANDALL
Active
Individual
MS. MICHELE T RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004863
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299822311A
—
GA
Enumeration date
01/23/2007
Last updated
08/24/2018
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