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1295325702
JENNIE RANDLE
SHEBOYGAN, WI
NPI
1295325702
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Former Name
JENNIE SPOONHOUR
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 3090)
Enumeration Date
2021-01-19
Last Update Date
2021-01-19
Business Address
JENNIE RANDLE PTA
2131 S BUSINESS DR
SHEBOYGAN, WI 53081-5656
Phone number: 920-917-7104
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Mailing Address
JENNIE RANDLE PTA
2131 S BUSINESS DR
SHEBOYGAN, WI 53081-5656
Phone number: 920-917-7104
Copy
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