| NPI | 1366473282 |
|---|---|
| Former Legal Business Name | NA |
| Entity Type | Organization |
| Authorized Contact | FATIMA L LAQUINDANUM Administrator 901-725-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT 5144) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO PT 103140) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-08-22 |