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Organization
MALCOM RANDAL VA MEDICAL CENTER
Active
Organization
MALCOM RANDAL VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYRA KENYATTA LINDSEY (KINESIOTHERAPIST)
(601) 214-7257
Entity
Organization
Contact information
Practice address
1601 SW ARCHER RD, GAINESVILLE, FL 32608-1135
(352) 376-1611
Mailing address
613 OLD JACKSON RD, MADISON, MS 39110-8250
(601) 214-7257
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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