Doctor Name: | RANDALL J SOUTHARD |
NPI Number: | 1497865018 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RPT |
License Number: | 11-02934 |
Business Practice Address: | 107 N Pine St Ste A Pittsburg, KS - 667624743 |
Business Phone Number: | 6202315855 |
Business Fax Number: | 6202315906 |
Mailing Address: | 107 N Pine St Ste A, Po Box 1539 PITTSBURG |
State: | KS |
Postal Code: | 667624743 |
Phone Number: | 6202315855 |
Fax Number: | 6202315906 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 12/06/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 11-02934 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |