Individual
MRS. AMY RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
1675 W TIPTON ST, SEYMOUR, IN 47274-8659
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06001298A
IN
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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