Individual
PEYTON FANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
670 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 328-1012
Mailing address
105 N PRIMROSE LN, STARKVILLE, MS 39759-4335
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5537
MS
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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