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General NPI Number Information
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NPI Number | 1336924356
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Entity Type | Individual
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Provider Name | RANDALL DOLAN KINSLOW PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1123 N MAIN AVE STE 211
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City | SAN ANTONIO
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State | TX
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Zip | 78212-4738
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Country | US
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Telephone | 210-226-2101
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Fax | 210-226-6445
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Provider Business Mailing Address
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Address Line | 2001 BUTTERFIELD RD STE 1600
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1211
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5391
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | TX
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