Healthcare Provider Details
I. General information
NPI: 1447504352
Provider Name (Legal Business Name): LEADER PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/30/2012
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6050 AIRLINE RD SUITE 106
ARLINGTON TN
38002-4895
US
IV. Provider business mailing address
5039 PARK AVE SUITE 102
MEMPHIS TN
38117-5701
US
V. Phone/Fax
- Phone: 901-867-8989
- Fax:
- Phone: 901-818-9746
- Fax: 901-818-9741
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
BINSTEIN
Title or Position: VP, AUTHORIZED OFFICIAL
Credential: JD
Phone: 713-297-7000