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Individual

CHRISTA DAWN RANDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
306 W MAIN ST, BRIDGEPORT, WV 26330-1751
(304) 842-3137
(304) 842-3138
Mailing address
306 W MAIN ST, BRIDGEPORT, WV 26330-1751
(304) 842-3137
(304) 842-3138

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
002526
WV
225100000X
Physical Therapist
Primary
002526
WV

Other

Enumeration date
12/13/2005
Last updated
07/12/2012
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