Tess Randolph

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Houtzdale, PA

NPI 1649980780 · NPPES record last updated Nov 30, 2022

Key facts

NPI
1649980780
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
354 N Railroad St
Houtzdale, PA 16651-8836
Phone
(814) 592-5841
NPI assigned
Nov 30, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

354 N Railroad St
Houtzdale, PA 16651-8836

Mailing address

354 N Railroad St
Houtzdale, PA 16651-8836

Other providers in Houtzdale, PA

All providers in Houtzdale, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania

Sources for this page

Verify at the official NPI Registry.