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NPI Code Detail

MEDICARE: JEFFREY RANDALL P.T.

MEDICARE: JEFFREY RANDALL P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPTL0007763CO

General Provider Information

NPI Number : 1598716045
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY RANDALL P.T.
Provider Business Mailing Address
First Line : PO BOX 5718
Second Line :
City : KALISPELL
State : MT
Zip : 59903-5718
Country : US
Telephone Number : 406-756-0134
Fax Number : 406-300-1612
Provider Business Practice Location Address
First Line : 9088 RIDGELINE BLVD STE 106
Second Line :
City : HIGHLANDS RANCH
State : CO
Zip : 80129-2380
Country : US
Telephone Number : 720-458-0522
Fax Number : 720-536-5365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 03/06/2020

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Directions to “ JEFFREY RANDALL P.T.” Practice Location

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