Organization
REHAB AT YOUR SPACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNA A AUSTIN (EXECUTIVE DIRECTOR)
(901) 409-1017
Entity
Organization
Contact information
Practice address
6320 N QUAIL HOLLOW RD, MEMPHIS, TN 38120-1420
(901) 409-1017
Mailing address
6320 N QUAIL HOLLOW RD, MEMPHIS, TN 38120-1420
(901) 409-1017
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251G0304X
Geriatric Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225400000X
Rehabilitation Practitioner
—
—
225X00000X
Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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