Individual
JESSICA RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 POSA PLACE, DARTMOUTH, MA 02747-2511
(508) 996-3391
Mailing address
1217 HOPE ST, BRISTOL, RI 02809-1125
(401) 396-9023
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15527
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000025645
BMC
MA
Enumeration date
02/28/2007
Last updated
07/08/2007
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