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1104215995
RANDY SIBOLE
LANCASTER, CA
NPI
1104215995
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: CA AT1130)
Enumeration Date
2015-01-15
Last Update Date
2015-01-15
Business Address
RANDY SIBOLE
3228 W AVENUE J3
LANCASTER, CA 93536-6184
Phone number: 661-942-5191
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Mailing Address
RANDY SIBOLE
3228 W AVENUE J3
LANCASTER, CA 93536-6184
Phone number: 661-942-5191
Copy
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