Individual
MRS. ANNE WILLY RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
6160 MISSION GORGE RD, SUITE 400, SAN DIEGO, CA 92120-3410
(619) 528-4000
Mailing address
5625 AZTEC DR, LA MESA, CA 91942-1947
(619) 460-2562
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
10222
CA
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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