Provider Demographics
NPI:1841317542
Name:MORROW, RANDALL FORREST (PT)
Entity type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:FORREST
Last Name:MORROW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 WENHAM DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-2656
Mailing Address - Country:US
Mailing Address - Phone:661-665-2472
Mailing Address - Fax:
Practice Address - Street 1:1200 DISCOVERY DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7032
Practice Address - Country:US
Practice Address - Phone:661-852-3677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21794225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist