Organization
MOMENTUM PHYSICAL REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTI L. PESCE (SYSTEMS ADMINISTRATOR)
(901) 257-3422
Entity
Organization
Contact information
Practice address
80 S PRESCOTT ST, MEMPHIS, TN 38111-4635
(901) 257-3422
(901) 257-3423
Mailing address
80 S PRESCOTT ST, MEMPHIS, TN 38111-4635
(901) 257-3422
(901) 257-3423
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000001467
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446657
—
TN
01
—
4004523
BLUECROSS BLUESHIELD
TN
Enumeration date
05/23/2005
Last updated
05/15/2023
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