Healthcare Provider Details
I. General information
NPI: 1912123373
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2007
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1835 NONCONNAH BLVD STE 159
MEMPHIS TN
38132-2116
US
IV. Provider business mailing address
1835 NONCONNAH BLVD STE 159
MEMPHIS TN
38132-2116
US
V. Phone/Fax
- Phone: 901-346-1287
- Fax: 901-346-0049
- Phone: 901-346-1287
- Fax: 901-346-0049
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DENNIS
FITZPATRICK
Title or Position: CFO
Credential:
Phone: 610-644-7824