Individual
SHELLY RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
4509 INTEGRIS PKWY STE 100, EDMOND, OK 73034-8696
(405) 657-3800
Mailing address
4509 INTEGRIS PKWY STE 100, EDMOND, OK 73034-8696
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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