Individual
RANDY CHARLES MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
270 PIERCE ST STE 207, KINGSTON, PA 18704-5141
(808) 348-0979
Mailing address
105 CIRCLE DR, HARDING, PA 18643-3019
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI004678
PA
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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