Individual
CODY RANDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3030 N CENTRAL AVE, 1407, PHOENIX, AZ 85012-2707
(602) 253-5100
Mailing address
7557 N DREAMY DRAW DR, UNIT 256, PHOENIX, AZ 85020-4651
(773) 663-5747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
AZ
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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