MEDICARE: BARTLETT THERAPY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1639166127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARTLETT THERAPY CENTER

Provider Business Mailing Address
First Line	:	5142 STAGE RD
Second Line	:	SUITE 101
City	:	MEMPHIS
State	:	TN
Zip	:	38134-3164
Country	:	US
Telephone Number	:	901-309-1501
Fax Number	:	901-309-0454

Provider Business Practice Location Address
First Line	:	5142 STAGE RD
Second Line	:	SUITE 101
City	:	MEMPHIS
State	:	TN
Zip	:	38134-3164
Country	:	US
Telephone Number	:	901-309-1501
Fax Number	:	901-309-0454

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. VIRGIL SMITH
Credential	:
Telephone Number	:	901-309-1501

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	01/08/2008

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Directions to “BARTLETT THERAPY CENTER ” Practice Location

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