Individual
RANDEL BRAD DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
112 N BLAINE AVE, SUITE A, CHANDLER, OK 74834-1223
(405) 258-8644
(405) 240-5145
Mailing address
PO BOX 57710, OKLAHOMA CITY, OK 73157-7710
(405) 258-8644
(405) 240-5145
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1809
OK
Other
Enumeration date
06/20/2006
Last updated
07/08/2007
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