Individual
MS. TONYA JEAN RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1601 BUTTERFIELD TRAIL, KANKAKEE, IL 60901
(815) 936-6500
(971) 206-5203
Mailing address
4560 SE INTERNATIONAL WAY, STE. 100, MILWAUKIE, OR 97222
(971) 206-5200
(971) 206-5203
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006052
IL
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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