Healthcare Provider Details
I. General information
NPI: 1730056110
Provider Name (Legal Business Name): MEMPHIS THOROUGHBREDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7126 FERNBANK LN
MEMPHIS TN
38125-4168
US
IV. Provider business mailing address
7126 FERNBANK LN
MEMPHIS TN
38125-4168
US
V. Phone/Fax
- Phone: 901-314-2874
- Fax:
- Phone: 901-314-2874
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080S0010X |
| Taxonomy | Pediatric Sports Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TOMMY
WASHINGTON
Title or Position: PRESIDENT
Credential: B.S., USATF I, II
Phone: 901-314-2874