Individual
CARL RANDOLPH RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1701 27TH ST E, BRADENTON, FL 34208-7831
(941) 747-3031
Mailing address
11493 WALDEN LOOP, PARRISH, FL 34219-7569
(941) 776-9903
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 539
FL
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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