Healthcare Provider Details

I. General information

NPI: 1578488987
Provider Name (Legal Business Name): RANDLEMAN PEARSALL KELTNER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 S HIGHWAY 99
FILLMORE UT
84631-5033
US

IV. Provider business mailing address

770 S HIGHWAY 99
FILLMORE UT
84631-5033
US

V. Phone/Fax

Practice location:
  • Phone: 435-743-6100
  • Fax:
Mailing address:
  • Phone: 435-743-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: