Basic Information
| Provider Information | |||||||||
| NPI: | 1225139751 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FORD | ||||||||
| FirstName: | FRANCES | ||||||||
| MiddleName: | GAIL | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6655 QUINCE RD | ||||||||
| Address2: | STE 101 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381198031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017559988 | ||||||||
| FaxNumber: | 9017552233 | ||||||||
| Practice Location | |||||||||
| Address1: | 6655 QUINCE RD | ||||||||
| Address2: | STE 101 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381198031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017559988 | ||||||||
| FaxNumber: | 9017552233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT0111 | TN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.