Individual
LISA HYDILYA RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1923 STATE ST, HARRISBURG, PA 17103-1641
(717) 695-9808
Mailing address
1923 STATE ST, HARRISBURG, PA 17103-1641
(717) 695-9808
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
PA
Other
Enumeration date
05/17/2010
Last updated
05/17/2010
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