IndividualActive
Brent Randall
NPI 1497913123 · Occupational Therapist · Kimberly, ID
Provider details
- NPI number
- 1497913123
- Entity type
- Individual
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- OT-556 (ID)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
302 Garnet Dr
Kimberly, ID 83341-1931
Phone: (208) 731-9799
Approximate (ZIP-level) locationGet directions
Mailing address
414 N Lincoln Ave Ste 5
Jerome, ID 83338-2300
Registry dates
- Enumerated
- 2008-05-29
- Last updated
- 2008-05-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.