Healthcare Provider Details

I. General information

NPI: 1528307592
Provider Name (Legal Business Name): CATHERINE MCGILL SHIRLEY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2013
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 JEFFERSON AVE RM 323
MEMPHIS TN
38105-4934
US

IV. Provider business mailing address

530 TIPTON RD
MUNFORD TN
38058-4795
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-4900
  • Fax:
Mailing address:
  • Phone: 901-359-6292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number9226
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number9226
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9226
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: