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Individual

MRS. TAMMY RANDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3053 W CRAIG RD # 192, NORTH LAS VEGAS, NV 89032-5124
(702) 461-1620
(702) 399-1507
Mailing address
3053 W CRAIG RD # 192, NORTH LAS VEGAS, NV 89032-5124
(702) 461-1620
(702) 399-1507

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
02/01/2016
Last updated
02/01/2016
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