Individual
MR. ANDREW O RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
275 WISTERIA BLVD, COVINGTON, GA 30016-7208
(770) 788-1963
(770) 788-1963
Mailing address
275 WISTERIA BLVD, COVINGTON, GA 30016-7208
(770) 788-1963
(770) 788-1963
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3600
GA
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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