Individual
KRYSTAL L. RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., ATC, VATL
Contact information
Practice address
5419 PARK AVE, RICHMOND, VA 23226-2031
(804) 307-8126
Mailing address
5419 PARK AVE, RICHMOND, VA 23226-2031
(804) 307-8126
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001326
VA
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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