Provider Demographics
NPI:1558536615
Name:RANDY L LINDSEY PT AT C INC PS COLVILLE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:RANDY L LINDSEY PT AT C INC PS COLVILLE PHYSICAL THERAPY
Other - Org Name:TIGER PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:P,T, AT, C
Authorized Official - Phone:509-684-5027
Mailing Address - Street 1:217 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99114-2903
Mailing Address - Country:US
Mailing Address - Phone:509-684-5027
Mailing Address - Fax:509-684-1033
Practice Address - Street 1:390351 HWY 20
Practice Address - Street 2:
Practice Address - City:CUSICK
Practice Address - State:WA
Practice Address - Zip Code:99119
Practice Address - Country:US
Practice Address - Phone:509-684-5027
Practice Address - Fax:509-684-1033
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RANDY L LINDSEY PT AT C INC PS COLVILLE PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-29
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy