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NPI Code Detail

MEDICARE: MR. RANDY DALE STINSON D.P.T.

MEDICARE:  MR. RANDY DALE STINSON  D.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 Therapist7702653-2401UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669788725
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RANDY DALE STINSON D.P.T.
Provider Business Mailing Address
First Line : 95 WHITE SAGE AVE STE C
Second Line :
City : DELTA
State : UT
Zip : 84624-5555
Country : US
Telephone Number : 435-864-2551
Fax Number : 435-864-3573
Provider Business Practice Location Address
First Line : 95 WHITE SAGE AVE STE C
Second Line :
City : DELTA
State : UT
Zip : 84624-5555
Country : US
Telephone Number : 435-864-2551
Fax Number : 435-864-3573
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2010
Last Update Date : 02/08/2012

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Directions to “ MR. RANDY DALE STINSON D.P.T.” Practice Location

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