Basic Information
| Provider Information | |||||||||
| NPI: | 1891863072 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSIOTHERAPY ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6655 QUINCE RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381198031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017559988 | ||||||||
| FaxNumber: | 9017552233 | ||||||||
| Practice Location | |||||||||
| Address1: | 6655 QUINCE RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381198031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017559988 | ||||||||
| FaxNumber: | 9017552233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HUFF | ||||||||
| AuthorizedOfficialFirstName: | JUD | ||||||||
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| AuthorizedOfficialTitleorPosition: | GENERAL MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9016857227 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.