Organization
UNIVERSITY OF TENNESSEE
Active
Other names
Boling Center for Developmental Disabilities, Center on Developmental Disabilities
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE KEISLING PHD (DIRECTOR)
(901) 448-6511
Entity
Organization
Contact information
Practice address
920 MADISON AVE STE 939, MEMPHIS, TN 38103-3438
(901) 448-6511
(901) 448-3844
Mailing address
920 MADISON AVE STE 939, MEMPHIS, TN 38103-3438
(901) 448-6511
(901) 448-3844
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
LM222M20956033
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4447962
—
TN
Enumeration date
07/31/2006
Last updated
08/14/2023
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