# SCOTT'S FAMILY FITNESS & PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326133455
- **Authorized official:** CONNY CHRISTL RANDOLPH (PHYSICAL THERAPIST)
- **Authorized official phone:** (601) 731-1140

## Contact information

- **Practice address:** 808 HWY 98 BYPASS, COLUMBIA, MS 39429-0429
- **Practice address phone:** (601) 731-1140
- **Practice address fax:** (601) 731-1148
- **Mailing address:** PO BOX 429, 808 HWY 98 BYPASS, COLUMBIA, MS 39429-0429
- **Mailing address phone:** (601) 731-1140
- **Mailing address fax:** (601) 731-1148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 08/07/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00121739 | — | MS |