MEDICARE: RUTH MULVANY PT

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
1	225100000X	Physical Therapist	234	TN

General Provider Information

NPI Number	:	1912089509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH MULVANY PT

Provider Business Mailing Address
First Line	:	930 MADISON AVE
Second Line	:	ROOM 638
City	:	MEMPHIS
State	:	TN
Zip	:	38163-2243
Country	:	US
Telephone Number	:	901-448-5888
Fax Number	:	901-448-1411

Provider Business Practice Location Address
First Line	:	930 MADISON AVE
Second Line	:	ROOM 638
City	:	MEMPHIS
State	:	TN
Zip	:	38163-2243
Country	:	US
Telephone Number	:	901-448-5888
Fax Number	:	901-448-1411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/08/2007

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Directions to “ RUTH MULVANY PT” Practice Location

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