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General NPI Number Information
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NPI Number | 1649782822
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Entity Type | Organization
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Legal Business Name | STEWART PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/28/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 2136 EXETER RD STE 102
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City | GERMANTOWN
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State | TN
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Zip | 38138-3935
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Country | US
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Telephone | 901-480-8336
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Fax |
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Provider Business Mailing Address
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Address Line | 896 RIVER PARK DR
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City | MEMPHIS
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State | TN
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Zip | 38103-0804
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Country | US
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Telephone | 901-233-6815
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JAMES R HAYNES III
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Credential |
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Telephone | 662-710-2844
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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 |
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License Number State |
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