Individual
HARRISON RANDALL FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, PES
Contact information
Practice address
228 17TH AVE NW, GREAT FALLS, MT 59404-1807
(406) 268-6100
Mailing address
228 17TH AVE NW, GREAT FALLS, MT 59404-1807
(406) 268-6100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR-LAT-LIC-2685
MT
Other
Enumeration date
12/21/2022
Last updated
12/21/2022
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