# SHIRES REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528696473
- **Authorized official:** JAY SHIRES MD (MD)
- **Authorized official phone:** (731) 660-2665

## Contact information

- **Practice address:** 180 MOUNT PELIA RD, MARTIN, TN 38237-3812
- **Practice address phone:** (731) 660-2665
- **Mailing address:** PO BOX 11942, JACKSON, TN 38308-0132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/27/2020
- **Last updated:** 09/09/2020