Individual
KENNETH EDWIN RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1111 S SAINT LOUIS AVE, TULSA, OK 74120-5440
(918) 619-4600
(918) 619-4601
Mailing address
4502 E 41ST ST, STE 2J30, TULSA, OK 74135-2553
(918) 660-3276
(918) 660-3297
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1372
OK
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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