Individual
JEFFREY MICHAEL RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1411 3RD ST, PORT HURON, MI 48060-5480
(586) 651-6059
Mailing address
17600 EIDER DR, CLINTON TOWNSHIP, MI 48038-7408
(586) 321-7217
(586) 286-4988
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010945
MI
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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