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General NPI Number Information
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NPI Number | 1659543635
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Entity Type | Organization
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Legal Business Name | TLC MEDICAL & PHYSICAL THERAPY CLINIC,LLC
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Dates
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Enumeration Date | 03/30/2008
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Last Update Date | 03/30/2008
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Provider Practice Location Address
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Address Line | 3624 AUSTIN PEAY HWY STE 1
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City | MEMPHIS
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State | TN
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Zip | 38128-3771
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Country | US
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Telephone | 901-372-7324
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Fax |
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Provider Business Mailing Address
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Address Line | 3624 AUSTIN PEAY HWY STE 1
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City | MEMPHIS
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State | TN
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Zip | 38128-3771
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Country | US
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Telephone | 901-372-7324
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MARIA CRISTINA CAPARAS MADARANG
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Credential | PT ATP
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Telephone | 901-372-7324
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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 |
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License Number State |
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