Individual
ELIZABETH RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4704 W DIANA AVE, GLENDALE, AZ 85302-5125
(623) 247-3949
Mailing address
4704 W DIANA AVE, GLENDALE, AZ 85302-5125
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10154A
AZ
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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