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NPI Code Detail

MEDICARE: LINDEN BELLEVUE INJURY CLINIC, LLC

MEDICARE: LINDEN BELLEVUE INJURY CLINIC, LLC
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1235427139
Entity Type Code : Organization
Provider Name (Legal Business Name) : LINDEN BELLEVUE INJURY CLINIC, LLC
Provider Business Mailing Address
First Line : 295 S BELLEVUE BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-7517
Country : US
Telephone Number : 901-725-0522
Fax Number : 901-725-0523
Provider Business Practice Location Address
First Line : 295 S BELLEVUE BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-7517
Country : US
Telephone Number : 901-725-0522
Fax Number : 901-725-0523
Authorized Official
Title or Position : REHAB DIRECTOR
Name : MS. RESA S BARAWID
Credential : PT
Telephone Number : 901-725-0522
Provider Enumeration Date : 07/13/2011
Last Update Date : 07/13/2011

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