Individual
MR. RANDOL ARIAS CORPORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 388-3000
Mailing address
5103 REGATTA POINTE RD, SUFFOLK, VA 23435-3525
(843) 271-0821
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306606124
VA
Other
Enumeration date
09/11/2024
Last updated
11/12/2024
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