Individual
DANETTE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
337 SHERI LN, LAKE JACKSON, TX 77566-3269
(979) 418-7165
Mailing address
1509 ANDREA DR, BAY CITY, TX 77414-3743
(361) 676-6011
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1095404
TX
Other
Enumeration date
04/07/2010
Last updated
05/26/2021
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