Individual ProviderRandall Scott SondrolPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address6341 University Ave NE, Fridley, MN 55432-4946(763) 572-5710PECOS EnrollmentBased on the most recent information from CMS, provider Randall Scott Sondrol does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1841390242Provider TypeIndividualFull NameSondrol, Randall ScottCredentialP.T.GenderMaleSole ProprietorNoEnumeration Date9/25/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address6341 University Ave NE, Fridley, MN 55432-4946Phone(763) 572-5710Fax(763) 586-5963Mailing LocationMailing Address6401 University Ave NE, Fridley, MN 55432-4341Phone(763) 572-5710Fax(763) 571-3008Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense6639MinnesotaProvider IdentifiersIDDescriptionIssuerID2013653DescriptionOtherIssuerAMERICA'S PPOMinnesotaID57G93SODescriptionOtherIssuerBCBS OF MNMinnesotaIDHP35077DescriptionOtherIssuerHEALTHPARTNERSMinnesotaID6404322DescriptionOtherIssuerMEDICAMinnesota