Individual
RANDALL LEE HUNTZBERRY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1601 SW ARCHER RD, GAINESVILLE, FL 32608-1135
(352) 376-1611
Mailing address
21211 45TH PL, LAKE CITY, FL 32024-2241
(386) 935-2416
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 19814
FL
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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