Provider Demographics
NPI:1326548314
Name:HULET, RANDALL (DPT)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:
Last Name:HULET
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7352 BRITISH RD
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-5507
Mailing Address - Country:US
Mailing Address - Phone:814-571-0724
Mailing Address - Fax:
Practice Address - Street 1:394 HARDING PL STE 200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3980
Practice Address - Country:US
Practice Address - Phone:615-834-4708
Practice Address - Fax:615-331-3508
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13642225100000X
GAPT015133225100000X
ALPTH10174225100000X
TNLPT-013642225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist