Individual
EMILY METTLACH RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2132 GAUSE BLVD E STE 6, SLIDELL, LA 70461-4243
(985) 646-2531
(985) 649-1391
Mailing address
2132 GAUSE BLVD E STE 6, SLIDELL, LA 70461-4243
(985) 646-2531
(985) 649-1391
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT4621
MS
2251X0800X
Orthopedic Physical Therapist
Primary
08268R
LA
Other
Enumeration date
10/20/2009
Last updated
07/08/2014
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