Organization
SCOTT'S FAMILY FITNESS & PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNY CHRISTL RANDOLPH (PHYSICAL THERAPIST)
(601) 731-1140
Entity
Organization
Contact information
Practice address
808 HWY 98 BYPASS, COLUMBIA, MS 39429-0429
(601) 731-1140
(601) 731-1148
Mailing address
PO BOX 429, 808 HWY 98 BYPASS, COLUMBIA, MS 39429-0429
(601) 731-1140
(601) 731-1148
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121739
—
MS
Enumeration date
10/04/2006
Last updated
08/07/2007
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