Individual
DAVID CHARLES RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
527 AVENUE B, MELBOURNE BEACH, FL 32951-2216
(321) 482-4982
Mailing address
527 AVENUE B, MELBOURNE BEACH, FL 32951-2216
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT22170
FL
Other
Enumeration date
03/14/2017
Last updated
03/14/2017
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