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General NPI Number Information
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NPI Number | 1376848713
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Entity Type | Organization
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Legal Business Name | OMEGA REHABILITATION GROUP, INC
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Dates
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Enumeration Date | 01/16/2011
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Last Update Date | 01/16/2011
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Provider Practice Location Address
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Address Line | 4202 HACKS CROSS RD SUITE: 114
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City | MEMPHIS
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State | TN
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Zip | 38125-3757
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Country | US
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Telephone | 901-754-7159
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Fax | 901-754-9540
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Provider Business Mailing Address
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Address Line | PO BOX 751982
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City | MEMPHIS
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State | TN
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Zip | 38175-1982
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Country | US
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Telephone | 901-754-7159
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Fax | 901-754-9540
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Authorized Official
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Title or Position | LEAD P.T.
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Name | CARLOS CATHEY
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Credential | P.T.
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Telephone | 901-754-7159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 5958
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License Number State | TN
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