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Individual

JONATHAN RANDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
36397 N GANTZEL RD, #102, SAN TAN VALLEY, AZ 85140-7335
(480) 567-2987
(480) 347-0240
Mailing address
3779 E IRONHORSE RD, GILBERT, AZ 85297-9417
(480) 385-9360

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
12483
AZ

Other

Enumeration date
08/23/2016
Last updated
08/23/2016
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