Individual
JARED THOMAS RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1614 W PARRISH AVE, OWENSBORO, KY 42301-3535
(270) 684-4559
Mailing address
1721 DANIELS LN, OWENSBORO, KY 42303-9675
(270) 929-8652
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02450
KY
Other
Enumeration date
01/23/2022
Last updated
01/23/2022
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