Organization
VETRANS ADMINISTRATION
Active
Organization
VETRANS ADMINISTRATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GRAY (PTA)
(901) 523-8990
Entity
Organization
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
1035 BOONES HOLLOW DR, CORDOVA, TN 38018-5889
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
—
—
Other
Enumeration date
07/16/2006
Last updated
08/22/2020
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