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NPI Code Detail

MEDICARE: ADVANCE THERAPY SERVICES LLC

MEDICARE: ADVANCE THERAPY SERVICES LLC
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
1252Y00000XEarly Intervention Provider Agency3164TN
2251300000XLocal Education Agency (LEA)3164TN

General Provider Information

NPI Number : 1679875447
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCE THERAPY SERVICES LLC
Provider Business Mailing Address
First Line : 1290 PINNACLE POINT DR
Second Line :
City : COLLIERVILLE
State : TN
Zip : 38017-1364
Country : US
Telephone Number : 901-428-3445
Fax Number : 901-854-9261
Provider Business Practice Location Address
First Line : 2597 AVERY AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38112-4818
Country : US
Telephone Number : 901-416-2700
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST/OWNER
Name : MRS. AMY E ALLEN
Credential : OTR/L
Telephone Number : 901-428-3445
Provider Enumeration Date : 11/29/2010
Last Update Date : 11/29/2010

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Directions to “ADVANCE THERAPY SERVICES LLC ” Practice Location

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