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General NPI Number Information
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NPI Number | 1144159294
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Entity Type | Organization
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Legal Business Name | BREAKTHROUGH PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 7154 HWY 45 N
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City | NETTLETON
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State | MS
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Zip | 38821
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Country | US
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Telephone | 662-591-1077
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Fax | 662-591-1024
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Provider Business Mailing Address
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Address Line | 60368 COTTON GIN PORT RD
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City | AMORY
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State | MS
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Zip | 38821-9104
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Country | US
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Telephone | 662-257-3669
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Fax | 662-257-3961
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Authorized Official
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Title or Position | OWNER
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Name | ZACHARY JAMES RANDOLPH
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Credential | DPT
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Telephone | 662-315-6583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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