Organization
ADVANCE WELLNESS CENTERS OF MEMPHIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL SONGSTAD (CEO)
(901) 207-6074
Entity
Organization
Contact information
Practice address
2715 KIRBY RD, SUITE 15, MEMPHIS, TN 38119-8238
(901) 207-6074
(901) 207-6086
Mailing address
2715 KIRBY RD, SUITE 15, MEMPHIS, TN 38119-8238
(901) 207-6074
(901) 207-6086
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
01/27/2015
Last updated
03/09/2015
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