Brent Randall

NPI #1497913123 in Kimberly, Idaho

Provider Information

NPI Number
1497913123
Entity Type
Individual
Name
Brent Randall
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Occupational Therapist
Enumeration Date
May 29, 2008
Last Updated
May 29, 2008

Practice Location

Address
302 GARNET DR
State
Idaho
ZIP Code
83341-1931
Phone
(208) 731-9799

Specialties & Taxonomy Codes

Specialty
Occupational Therapist

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