Individual
IAN RANDANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
298 TRICORN RD, DANVILLE, WV 25053-7148
(303) 043-6913
Mailing address
PO BOX 102, SYLVESTER, WV 25193-0102
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1526
WV
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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