Individual
ALYSE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
8100 W 78TH ST, SUITE #225, EDINA, MN 55439-2516
(952) 946-9777
Mailing address
8100 W 78TH ST, SUITE #225, EDINA, MN 55439-2516
(952) 946-9777
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2299
MN
Other
Enumeration date
12/27/2011
Last updated
12/27/2011
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