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General NPI Number Information
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NPI Number | 1235920877
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Entity Type | Individual
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Provider Name | VANESSA PEZESHK PT,DPT
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1211 UNION AVE STE 195
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City | MEMPHIS
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State | TN
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Zip | 38104-6603
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Country | US
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Telephone | 901-759-3280
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Fax |
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Provider Business Mailing Address
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Address Line | 755 COLEHERNE RD
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City | COLLIERVILLE
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State | TN
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Zip | 38017-7322
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Country | US
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Telephone | 901-833-1192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0000011355
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License Number State | TN
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