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General NPI Number Information
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NPI Number | 1427121953
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Entity Type | Individual
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Provider Name | TONI LEE RANDALL LPTA
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 35104 EUCLID AVE SUITE #311
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City | WILLOUGHBY
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State | OH
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Zip | 44094-4516
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Country | US
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Telephone | 440-954-7061
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Fax | 440-954-7065
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Provider Business Mailing Address
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Address Line | 4570 HILLAND DR
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City | CLEVELAND
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State | OH
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Zip | 44109-4529
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Country | US
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Telephone | 216-741-4378
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Fax | 216-741-4396
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 01123
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License Number State | OH
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