Provider Demographics
NPI:1700123932
Name:RIMBEY, RANDELL ALAN (MS ATC PES)
Entity type:Individual
Prefix:
First Name:RANDELL
Middle Name:ALAN
Last Name:RIMBEY
Suffix:
Gender:M
Credentials:MS ATC PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 SEAHORSE LN
Mailing Address - Street 2:
Mailing Address - City:CHRISTCHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:23031-0001
Mailing Address - Country:US
Mailing Address - Phone:804-695-4734
Mailing Address - Fax:
Practice Address - Street 1:49 SEAHORSE LN
Practice Address - Street 2:
Practice Address - City:CHRISTCHURCH
Practice Address - State:VA
Practice Address - Zip Code:23031-0001
Practice Address - Country:US
Practice Address - Phone:804-695-4734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260002192255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer