Individual
MR. CHRISTOPHER BLAKE RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PT.
Contact information
Practice address
4101 WESLEY ST, SUITE H, GREENVILLE, TX 75401-5635
(903) 454-8100
(903) 454-1180
Mailing address
102 SPRINGFIELD DRIVE, COOPER, TX 75432
(903) 395-4835
(903) 886-7679
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1151637
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T1324
BCBS PROVIDER
TX
Enumeration date
08/04/2006
Last updated
07/08/2007
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