NPI 1083271993

Brandy Nicole Randolph, PTA

Practitioner Physical Therapy Assistant Broken Arrow, OK

Practice location

Address: 17110 E 51st St, Broken Arrow, OK 74012-9279
Phone: (918) 355-1596
Mailing address: 2914 S 125th East Ave, Tulsa, OK 74129-8427

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 1957 (OK)

Other Physical Therapy Assistant providers in Oklahoma →

Registry record

NPI: 1083271993
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 May 2019
Record last updated: 27 May 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.