Individual
RANDY SIBOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3228 W AVENUE J3, LANCASTER, CA 93536-6184
(661) 942-5191
Mailing address
3228 W AVENUE J3, LANCASTER, CA 93536-6184
(661) 942-5191
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT1130
CA
Other
Enumeration date
01/15/2015
Last updated
01/15/2015
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