Individual
JUDSON H RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
412 S HOWARD AVE, TAMPA, FL 33606-1770
(813) 244-4760
Mailing address
PO BOX 126, SAFETY HARBOR, FL 34695
(813) 244-4760
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA44803
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235309683
NPI
FL
Enumeration date
03/01/2008
Last updated
07/13/2010
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