Healthcare Provider Details

I. General information

NPI: 1568678464
Provider Name (Legal Business Name): DAWN MICHELLE BIERDZ P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1789 KIRBY PKWY SUITE 3
MEMPHIS TN
38138-3608
US

IV. Provider business mailing address

7083 GUNLOCK DR
MILLINGTON TN
38053-3990
US

V. Phone/Fax

Practice location:
  • Phone: 901-759-1282
  • Fax: 901-759-1290
Mailing address:
  • Phone: 901-759-1282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0000006107
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: