Individual
JENNIE RANDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2131 S BUSINESS DR, SHEBOYGAN, WI 53081-5656
(920) 917-7104
Mailing address
2131 S BUSINESS DR, SHEBOYGAN, WI 53081-5656
(920) 917-7104
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3090
WI
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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