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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Tuesday, May 7, 2024 9:05 AM CDT
Next Update: Tuesday, May 7, 2024 12:00 PM CDT

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RANDOLPH, NICHOLAS SHANE
Practice Address: 2225 N MAIN ST
MIAMI OK 74354

Address last updated on 1/5/2024
Phone #: (918) 542-4101
Fax #:
County: OTTAWA
License: 2852
Dated: 10/13/2017
Expires: 1/31/2025
License Type: Physical Therapist Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
2225 N MAIN ST
MIAMI OK 74354

Phone #: (918) 542-4101
Fax #:

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