Provider Demographics
NPI:1033174321
Name:RANDA, ANNA THAMES (ATC, NREMT-I)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:THAMES
Last Name:RANDA
Suffix:
Gender:F
Credentials:ATC, NREMT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:PO BOX 1472
Mailing Address - Street 2:UGA SPORTS MEDICINE DEPARTMENT
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30603-1472
Mailing Address - Country:US
Mailing Address - Phone:706-542-7892
Mailing Address - Fax:706-542-7707
Practice Address - Street 1:100 SMITH STREET
Practice Address - Street 2:UGA SPORTS MEDICINE DEPARTMENT
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30603-1472
Practice Address - Country:US
Practice Address - Phone:706-542-7892
Practice Address - Fax:706-542-7707
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAAT0009632255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer