Individual
MR. ELLEN F RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2629 W 23RD ST, PANAMA CITY, FL 32405-2311
(850) 832-7786
Mailing address
2929 KINGSWOOD DR, PANAMA CITY, FL 32405-2049
(850) 832-7786
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA31576
FL
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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