Individual
MR. LANDIS RANDALL MAINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
9980 W GLENDALE AVE STE 110, GLENDALE, AZ 85307-3005
(623) 242-6908
Mailing address
3212 W WALTER WAY, PHOENIX, AZ 85027-1075
(520) 861-4502
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
LPT31413
AZ
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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