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General NPI Number Information
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NPI Number | 1760198949
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Entity Type | Organization
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Legal Business Name | NEURO REHAB OF THE MID-SOUTH
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 5810 SHELBY OAKS DR STE B
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City | MEMPHIS
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State | TN
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Zip | 38134-7315
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Country | US
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Telephone | 870-565-6139
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Fax |
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Provider Business Mailing Address
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Address Line | 10477 LOW BRIDGE RD
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-5584
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Country | US
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Telephone | 870-565-6139
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST, OWNER
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Name | CASSIE HANSON
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Credential | OTD, OTR/L
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Telephone | 870-565-6139
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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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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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