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General NPI Number Information
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NPI Number | 1235151986
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Entity Type | Organization
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Legal Business Name | RANDY L LINDSEY PT AT C INC PS
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 217 E 2ND AVE
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City | COLVILLE
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State | WA
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Zip | 99114-2903
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Country | US
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Telephone | 509-684-5027
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Fax | 509-684-6133
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Provider Business Mailing Address
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Address Line | 217 E 2ND AVE
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City | COLVILLE
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State | WA
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Zip | 99114-2903
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Country | US
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Telephone | 509-684-5027
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Fax | 509-684-6133
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Authorized Official
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Title or Position | OWNER
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Name | CAROL BRADEEN
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Credential |
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Telephone | 509-991-1326
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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 | WA
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