Jeremiah Thomas Randall
Physical Therapist - Sports
1336 N Walnut St
Iola
, Kansas 66749-1601
Jeremiah Thomas Randall
Physical Therapist - Sports
1336 N Walnut St
Iola
, Kansas 66749-1601
(913) 645-0264
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About
Features
Specialties
- Physical Therapist - Sports
Languages spoken
- English
Location
First Address
- Jeremiah Thomas Randall
- 10684 W 825 Rd
- Mound City, KS
- Zip : 66056-9112
- Phone : (913) 645-0264
Second Address
- Jeremiah Thomas Randall
- 1336 N Walnut St
- Iola, KS
- Zip : 66749-1601
- Phone : (620) 365-6989
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251S0007X | Physical Therapist - Sports | 11-04026 | KS |
| N | 2251S0007X | Physical Therapist - Sports | 24988 | FL |
National Provider Identifier
| NPI | 1366770828 |
|---|---|
| Provider Name | Jeremiah Thomas Randall |
| First Address | Mound City, KS 66056-9112 |
| Second Address | Iola, KS 66749-1601 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/11/2009 |
| Last Update Date | 21/11/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.