Individual
JENNIFER RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
488 E 11TH AVE STE 150A, EUGENE, OR 97401-3601
(541) 505-7134
Mailing address
5300 DUTCH HILL RD, CINCINNATUS, NY 13040-2106
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
039567
NY
225100000X
Physical Therapist
Primary
10748
CT
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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