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1205671427

NPI Code Detail

MEDICARE: RANDALL COLE PT

MEDICARE: RANDALL COLE PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	CP053295T	TN
2	225100000X	Physical Therapist	PT.PT.70143970-CP	WA
3	225100000X	Physical Therapist	PT7773	MS
4	225100000X	Physical Therapist	CP031979T	NC

General Provider Information

NPI Number	:	1205671427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDALL COLE PT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	5619 CAROLINA BEACH RD STE 120
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2815
Country	:	US
Telephone Number	:	910-790-1976
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2024
Last Update Date	:	06/08/2026

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Directions to “ RANDALL COLE PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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