Individual
RANDY PARENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
604 1ST ST NE, FOREST LAKE, MN 55025-1202
(651) 466-1025
Mailing address
604 1ST ST NE, FOREST LAKE, MN 55025-1202
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A12
MN
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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