Healthcare Provider Details

I. General information

NPI: 1437878774
Provider Name (Legal Business Name): MSK GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1582 GREEN T ROAD SUITE C
HERNANDO MS
38632
US

IV. Provider business mailing address

6077 PRIMACY PARKWAY SUITE 140
MEMPHIS TN
38119-5754
US

V. Phone/Fax

Practice location:
  • Phone: 901-259-1600
  • Fax: 901-259-1698
Mailing address:
  • Phone: 901-259-1673
  • Fax: 901-259-7637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRIS RUSCITTO
Title or Position: CFO
Credential:
Phone: 901-641-3000