Most Relevant Information
Provider Data
| NPI Number: | 1003427444 |
| Provider Name: | LANDIS RANDALL MAINS PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 2251X0800X |
| Specialty: | Physical Therapist |
| License Number: | LPT31413 |
Most Important Dates
| Enumeration Date: | 08/10/2020 |
| Last Updated: | 08/10/2020 |
Provider Practice Location
9980 W GLENDALE AVE STE 110
GLENDALE
AZ
853073005
Practice Location Phone/Fax
| Phone: | 6232426908 |
| Fax: |
Provider Mailing Location
3212 W WALTER WAY
PHOENIX
AZ
850271075
Provider Mailing Phone/Fax
| Phone: | 5208614502 |
| Fax: |